Provider Demographics
NPI:1801196241
Name:ZIPPI, CARL M (RPH)
Entity Type:Individual
Prefix:MR
First Name:CARL
Middle Name:M
Last Name:ZIPPI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32951-2369
Mailing Address - Country:US
Mailing Address - Phone:321-725-5492
Mailing Address - Fax:321-728-8794
Practice Address - Street 1:200 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:MELBOURNE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32951-2369
Practice Address - Country:US
Practice Address - Phone:321-725-5492
Practice Address - Fax:321-728-8794
Is Sole Proprietor?:No
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS22761183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist