Healthcare Provider Details

I. General information

NPI: 1811236425
Provider Name (Legal Business Name): ZIPPER SURGICAL ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2013
Last Update Date: 04/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 S HARBOR CITY BLVD SUITE 101
MELBOURNE FL
32901-1966
US

IV. Provider business mailing address

1130 S HARBOR CITY BLVD SUITE 101
MELBOURNE FL
32901-1966
US

V. Phone/Fax

Practice location:
  • Phone: 321-674-2114
  • Fax: 321-674-2118
Mailing address:
  • Phone: 321-914-4211
  • Fax: 321-914-4212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberME76190
License Number StateFL

VIII. Authorized Official

Name: DR. RALPH ZIPPER
Title or Position: PRESIDENT
Credential: MD
Phone: 321-914-4211