Healthcare Provider Details

I. General information

NPI: 1467411975
Provider Name (Legal Business Name): JEFFREY A. ZIPPER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2006
Last Update Date: 07/28/2022
Certification Date: 07/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6405 CONGRESS AVE STE 160
BOCA RATON FL
33487-2861
US

IV. Provider business mailing address

5030 CHAMPION BLVD STE G11-535
BOCA RATON FL
33496-2473
US

V. Phone/Fax

Practice location:
  • Phone: 561-286-4457
  • Fax: 561-464-5501
Mailing address:
  • Phone: 561-235-7666
  • Fax: 561-948-0989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License NumberME57494
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberME57494
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License Number55967
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License NumberMD2021-1162
License Number StateNM
# 5
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License NumberME57494
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberME57494
License Number StateFL
# 7
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number57494
License Number StateFL
# 8
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberME57494
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: