Provider Demographics
NPI:1073729240
Name:RALPH ZIPPER MD PA
Entity Type:Organization
Organization Name:RALPH ZIPPER MD PA
Other - Org Name:ZIPPER UROGYNECOLOGY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIPPER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-674-2114
Mailing Address - Street 1:200 S HARBOR CITY BLVD STE 401
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-1389
Mailing Address - Country:US
Mailing Address - Phone:321-674-2114
Mailing Address - Fax:321-674-2118
Practice Address - Street 1:200 S HARBOR CITY BLVD STE 401
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-1389
Practice Address - Country:US
Practice Address - Phone:321-674-2114
Practice Address - Fax:321-674-2118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME76190207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL277469100Medicaid
FLAG723Medicare PIN