Healthcare Provider Details

I. General information

NPI: 1578819165
Provider Name (Legal Business Name): LAUREN RACHEL ZIPES DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2012
Last Update Date: 06/17/2013
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

Practice location:
  • Phone: 954-979-9795
  • Fax: 954-979-1926
Mailing address:
  • Phone: 954-979-9795
  • Fax: 954-979-1926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO3563
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: