Provider Demographics
NPI:1063447522
Name:LIPSMAN, SAUL (DP M)
Entity Type:Individual
Prefix:
First Name:SAUL
Middle Name:
Last Name:LIPSMAN
Suffix:
Gender:M
Credentials:DP M
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6894 LAKE WORTH RD
Mailing Address - Street 2:SUITE #102
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467
Mailing Address - Country:US
Mailing Address - Phone:561-967-7600
Mailing Address - Fax:561-967-7177
Practice Address - Street 1:6894 LAKE WORTH RD
Practice Address - Street 2:SUITE #102
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467
Practice Address - Country:US
Practice Address - Phone:561-967-7600
Practice Address - Fax:561-967-7177
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLP0571213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL87281OtherBLUE SHIELD
T95483Medicare UPIN
FL87281OtherBLUE SHIELD