Provider Demographics
NPI:1720780026
Name:HIPP, BRYANNA HARRIS (MD)
Entity Type:Individual
Prefix:
First Name:BRYANNA
Middle Name:HARRIS
Last Name:HIPP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 PARKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-7308
Mailing Address - Country:US
Mailing Address - Phone:407-924-2630
Mailing Address - Fax:
Practice Address - Street 1:1775 DEMPSTER ST,
Practice Address - Street 2:MALBOX #48
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068
Practice Address - Country:US
Practice Address - Phone:847-723-2210
Practice Address - Fax:847-723-6987
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-20
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program