Healthcare Provider Details

I. General information

NPI: 1235410549
Provider Name (Legal Business Name): AVRON H LIPSCHITZ MD PLASTIC SURGERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2011
Last Update Date: 06/11/2021
Certification Date: 06/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

903 SE MONTEREY COMMONS BLVD
STUART FL
34996-3339
US

IV. Provider business mailing address

903 SE MONTEREY COMMONS BLVD
STUART FL
34996-3339
US

V. Phone/Fax

Practice location:
  • Phone: 727-324-8197
  • Fax: 772-324-8143
Mailing address:
  • Phone: 772-324-8197
  • Fax: 772-324-8143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberME108557
License Number StateFL

VIII. Authorized Official

Name: DR. AVRON HERSCHEL LIPSCHITZ
Title or Position: DOCTOR
Credential: MD
Phone: 772-324-8197