Provider Demographics
NPI:1336343102
Name:LIPSCHITZ, AVRON H (MD)
Entity Type:Individual
Prefix:
First Name:AVRON
Middle Name:H
Last Name:LIPSCHITZ
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 1:903 SE MONTEREY BLVD
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34996-3339
Mailing Address - Country:US
Mailing Address - Phone:772-324-8197
Mailing Address - Fax:772-324-8143
Practice Address - Street 1:903 SE MONTEREY COMMONS BLVD
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34996
Practice Address - Country:US
Practice Address - Phone:772-324-8197
Practice Address - Fax:772-324-8143
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME108557208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
BP1-0017846OtherINSTITUTIONAL PERMIT
FL1235410549OtherGROUP NPI
FL12247361OtherHCAQ
FL1235410549OtherGROUP NPI