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General NPI Number Information
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NPI Number | 1235343302
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Entity Type | Organization
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Legal Business Name | MORRIS J LIPNIK MD PA
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 09/03/2016
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Provider Practice Location Address
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Address Line | 27730 RIVERWALK WAY
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City | BONITA SPRINGS
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State | FL
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Zip | 34134-8691
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Country | US
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Telephone | 239-498-2207
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Fax | 239-498-5006
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Provider Business Mailing Address
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Address Line | PO BOX 1783
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City | MOUNT DORA
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State | FL
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Zip | 32756-1783
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Country | US
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Telephone | 877-277-7077
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Fax | 734-789-9152
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MORRIS J LIPNIK
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Credential | MD
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Telephone | 239-498-2207
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | ME 033321
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License Number State | FL
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