Basic Information
| Provider Information | |||||||||
| NPI: | 1053473330 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MADELYN B LIPMAN MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7301 N UNIVERSITY DR | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | TAMARAC | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333212919 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9547262000 | ||||||||
| FaxNumber: | 9547263109 | ||||||||
| Practice Location | |||||||||
| Address1: | 7301 N UNIVERSITY DR | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | TAMARAC | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333212919 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9547262000 | ||||||||
| FaxNumber: | 9547263109 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/14/2006 | ||||||||
| LastUpdateDate: | 07/12/2010 | ||||||||
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| AuthorizedOfficialLastName: | LIPMAN | ||||||||
| AuthorizedOfficialFirstName: | MADELYN | ||||||||
| AuthorizedOfficialMiddleName: | BARBARA | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9547262000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207NS0135X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Dermatology | Procedural Dermatology |
ID Information
| ID | Type | State | Issuer | Description | 1285611582 | 01 | FL | GLENN ZELLMAN, NPI NUMBER | OTHER | 1659358521 | 01 | FL | MADELYN LIPMAN NPI NUMBER | OTHER |