Healthcare Provider Details

I. General information

NPI: 1982907895
Provider Name (Legal Business Name): THOMAS E LIPIN MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2010
Last Update Date: 12/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 JUPITER LAKES BLVD BUILDING 3000, SUITE 202
JUPITER FL
33458-7191
US

IV. Provider business mailing address

210 JUPITER LAKES BLVD BUILDING 3000, SUITE 202
JUPITER FL
33458-7191
US

V. Phone/Fax

Practice location:
  • Phone: 561-746-2114
  • Fax: 561-746-9583
Mailing address:
  • Phone: 561-746-2114
  • Fax: 561-746-9583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: THOMAS E LIPIN
Title or Position: OWNER
Credential: MD
Phone: 561-746-2114