Provider Demographics
NPI:1407500390
Name:BENJAMIN E. LIPPMANN, D.O., P.A.
Entity Type:Organization
Organization Name:BENJAMIN E. LIPPMANN, D.O., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:ELLIOT
Authorized Official - Last Name:LIPPMANN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:863-289-0968
Mailing Address - Street 1:5302 S FLORIDA AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-4910
Mailing Address - Country:US
Mailing Address - Phone:863-289-0968
Mailing Address - Fax:
Practice Address - Street 1:5302 S FLORIDA AVE STE 206
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-4910
Practice Address - Country:US
Practice Address - Phone:863-289-0968
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty