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General NPI Number Information
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NPI Number | 1629166541
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Entity Type | Organization
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Legal Business Name | BENJAMIN TRIPP M D P A
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 05/20/2009
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Provider Practice Location Address
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Address Line | 5130 LINTON BLVD SUITE C-1
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City | DELRAY BEACH
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State | FL
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Zip | 33484-6596
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Country | US
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Telephone | 561-499-8048
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Fax | 561-499-8762
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Provider Business Mailing Address
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Address Line | 5130 LINTON BLVD SUITE C-1
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City | DELRAY BEACH
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State | FL
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Zip | 33484-6596
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Country | US
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Telephone | 561-499-8048
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Fax | 561-499-8762
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Authorized Official
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Title or Position | OWNER
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Name | BENJAMIN M TRIPP
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Credential | M.D.
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Telephone | 561-499-8048
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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