Provider Demographics
NPI:1295477743
Name:LIPIN, CONNER THOMAS (DO)
Entity type:Individual
Prefix:DR
First Name:CONNER
Middle Name:THOMAS
Last Name:LIPIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 TIERRA LN APT 11
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33477-7260
Mailing Address - Country:US
Mailing Address - Phone:561-629-2202
Mailing Address - Fax:
Practice Address - Street 1:703 N FLAMINGO RD FL 2
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-1014
Practice Address - Country:US
Practice Address - Phone:954-844-0250
Practice Address - Fax:954-276-0248
Is Sole Proprietor?:No
Enumeration Date:2022-04-13
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program