Healthcare Provider Details

I. General information

NPI: 1487745170
Provider Name (Legal Business Name): PAUL GIPPS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 05/10/2022
Certification Date: 05/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8608 BIRD RD
MIAMI FL
33155-3216
US

IV. Provider business mailing address

7200 CORPORATE CENTER DR SUITE 600
MIAMI FL
33126-1200
US

V. Phone/Fax

Practice location:
  • Phone: 305-551-3200
  • Fax: 305-222-1713
Mailing address:
  • Phone: 305-500-2000
  • Fax: 305-500-2080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME87199
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: