Provider Demographics
NPI:1053473330
Name:MADELYN B LIPMAN MD PA
Entity Type:Organization
Organization Name:MADELYN B LIPMAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MADELYN
Authorized Official - Middle Name:BARBARA
Authorized Official - Last Name:LIPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-726-2000
Mailing Address - Street 1:7301 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2919
Mailing Address - Country:US
Mailing Address - Phone:954-726-2000
Mailing Address - Fax:954-726-3109
Practice Address - Street 1:7301 N UNIVERSITY DR
Practice Address - Street 2:SUITE 102
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2919
Practice Address - Country:US
Practice Address - Phone:954-726-2000
Practice Address - Fax:954-726-3109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1285611582OtherGLENN ZELLMAN, NPI NUMBER
FL1659358521OtherMADELYN LIPMAN NPI NUMBER
FL77636Medicare ID - Type UnspecifiedGROUP NUMBER
FL1659358521OtherMADELYN LIPMAN NPI NUMBER
FLD78934Medicare UPIN