Provider Demographics
NPI:1356432330
Name:RIPPIS, GEORGE E (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:E
Last Name:RIPPIS
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 1:1335 VALENTINE ST
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-3127
Mailing Address - Country:US
Mailing Address - Phone:321-956-2986
Mailing Address - Fax:321-956-9430
Practice Address - Street 1:1335 VALENTINE ST
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-3127
Practice Address - Country:US
Practice Address - Phone:321-956-2986
Practice Address - Fax:321-956-9430
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2014-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207ZD0900X207ZD0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL27763OtherBC/BS OF FL
FL220032518OtherRAILROAD MEDICARE
FL379925500Medicaid
FL379925500Medicaid