MEDICARE: DR. DAVID L LIPORACE D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	OS5607	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184610818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID L LIPORACE D.O.

Provider Business Mailing Address
First Line	:	580 VILLAGE BLVD
Second Line	:	SUITE 210
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-1904
Country	:	US
Telephone Number	:	561-688-5030
Fax Number	:	561-688-9565

Provider Business Practice Location Address
First Line	:	580 VILLAGE BLVD
Second Line	:	SUITE 210
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-1904
Country	:	US
Telephone Number	:	561-688-5030
Fax Number	:	561-688-9565

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2005
Last Update Date	:	05/21/2013

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