Healthcare Provider Details
I. General information
NPI: 1316386972
Provider Name (Legal Business Name): ZIPES PODIATRY PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/17/2013
Last Update Date: 06/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5432 W SAMPLE RD
MARGATE FL
33073-3453
US
IV. Provider business mailing address
5432 W SAMPLE RD
MARGATE FL
33073-3453
US
V. Phone/Fax
- Phone: 954-979-9795
- Fax: 954-979-1926
- Phone: 954-979-9795
- Fax: 954-979-1926
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | PO3563 |
| License Number State | FL |
VIII. Authorized Official
Name: DR.
LAUREN
ZIPES
Title or Position: PRESIDENT
Credential:
Phone: 954-979-9795