Basic Information
| Provider Information | |||||||||
| NPI: | 1174657167 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LUPIS | ||||||||
| FirstName: | FRANCESCO | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8400 NW 33RD ST | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | DORAL | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331221937 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7864088502 | ||||||||
| FaxNumber: | 3054020855 | ||||||||
| Practice Location | |||||||||
| Address1: | 196 KITTS LN | ||||||||
| Address2: | |||||||||
| City: | NEWINGTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061114250 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8443074827 | ||||||||
| FaxNumber: | 3054020855 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2007 | ||||||||
| LastUpdateDate: | 10/18/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 35090341 | OH | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 050637 | CT | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207P00000X | 50637 | CT | N | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 2843383 | 05 | OH | MEDICAID | 344441792 | 01 | TAX IDENTIFICATION NUMBER UNDER MAGRUDER HOSPITAL | OTHER |