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General NPI Number Information
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NPI Number | 1053321224
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Entity Type | Organization
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Legal Business Name | VINCENT J TRIPI DO PA
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 01/09/2013
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Provider Practice Location Address
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Address Line | 1521 E MEMORIAL BLVD
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City | LAKELAND
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State | FL
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Zip | 33801-2222
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Country | US
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Telephone | 863-802-8200
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Fax | 863-802-8100
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Provider Business Mailing Address
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Address Line | 1521 E MEMORIAL BLVD
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City | LAKELAND
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State | FL
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Zip | 33801-2222
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Country | US
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Telephone | 863-802-8200
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Fax | 863-802-8100
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Authorized Official
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Title or Position | OWNER
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Name | VINCENT J TRIPI
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Credential | DO
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Telephone | 763-802-8200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | OS1373
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License Number State | FL
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