MEDICARE: ZIPPER SURGICAL ASSOCIATES, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VX0000X	Obstetrics Physician	ME76190	FL

General Provider Information

NPI Number	:	1811236425
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZIPPER SURGICAL ASSOCIATES, PA

Provider Business Mailing Address
First Line	:	1130 S HARBOR CITY BLVD
Second Line	:	SUITE 101
City	:	MELBOURNE
State	:	FL
Zip	:	32901-1966
Country	:	US
Telephone Number	:	321-914-4211
Fax Number	:	321-914-4212

Provider Business Practice Location Address
First Line	:	1130 S HARBOR CITY BLVD
Second Line	:	SUITE 101
City	:	MELBOURNE
State	:	FL
Zip	:	32901-1966
Country	:	US
Telephone Number	:	321-674-2114
Fax Number	:	321-674-2118

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RALPH ZIPPER
Credential	:	MD
Telephone Number	:	321-914-4211

Provider Enumeration Date	:	02/04/2013
Last Update Date	:	04/30/2013

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