Provider Demographics
NPI:1811236425
Name:ZIPPER SURGICAL ASSOCIATES, PA
Entity Type:Organization
Organization Name:ZIPPER SURGICAL ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
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:321-914-4211
Mailing Address - Street 1:1130 S HARBOR CITY BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-1966
Mailing Address - Country:US
Mailing Address - Phone:321-914-4211
Mailing Address - Fax:321-914-4212
Practice Address - Street 1:1130 S HARBOR CITY BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-1966
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:2013-02-04
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME76190207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL44254YMedicare PIN