Provider Demographics
NPI:1245263987
Name:DR ADAM P LIPKIN MD PA
Entity type:Organization
Organization Name:DR ADAM P LIPKIN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:P
Authorized Official - Last Name:LIPKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-475-5431
Mailing Address - Street 1:779 MEDICAL DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34223-5234
Mailing Address - Country:US
Mailing Address - Phone:941-475-5431
Mailing Address - Fax:941-475-1753
Practice Address - Street 1:779 MEDICAL DR
Practice Address - Street 2:SUITE 1
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34223-5234
Practice Address - Country:US
Practice Address - Phone:941-475-5431
Practice Address - Fax:941-475-1753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK9554OtherMEDICARE PTAN