Provider Demographics
NPI:1720379365
Name:LIPARI, BRIAN ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:ANTHONY
Last Name:LIPARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12989 SOUTHERN BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-9205
Mailing Address - Country:US
Mailing Address - Phone:561-268-2880
Mailing Address - Fax:
Practice Address - Street 1:12989 SOUTHERN BLVD STE 103
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470
Practice Address - Country:US
Practice Address - Phone:561-268-2880
Practice Address - Fax:561-268-2881
Is Sole Proprietor?:No
Enumeration Date:2011-05-01
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME117518207QA0505X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME117518OtherMEDICAL LICENSE
FLFL4176118OtherDEA