Provider Demographics
NPI:1790216455
Name:LIPMAN, MALORIE (MD)
Entity type:Individual
Prefix:
First Name:MALORIE
Middle Name:
Last Name:LIPMAN
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 1:1921 WALDEMERE ST STE 802
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2913
Mailing Address - Country:US
Mailing Address - Phone:941-917-7888
Mailing Address - Fax:
Practice Address - Street 1:1921 WALDEMERE ST STE 802
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2913
Practice Address - Country:US
Practice Address - Phone:941-917-7888
Practice Address - Fax:941-917-6314
Is Sole Proprietor?:No
Enumeration Date:2017-03-24
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC390200000X
FLME149928207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program