Provider Demographics
NPI:1053319350
Name:LIPKIN, DAVID L (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:L
Last Name:LIPKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 630127
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33163-0127
Mailing Address - Country:US
Mailing Address - Phone:305-672-1256
Mailing Address - Fax:305-672-1266
Practice Address - Street 1:4302 ALTON RD
Practice Address - Street 2:SUITE 420
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2891
Practice Address - Country:US
Practice Address - Phone:305-672-1256
Practice Address - Fax:305-672-1266
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME14045208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL069011200Medicaid
FLD59079Medicare UPIN
FL90180WMedicare ID - Type Unspecified