Basic Information
| Provider Information | |||||||||
| NPI: | 1811236425 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ZIPPER SURGICAL ASSOCIATES, PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1130 S HARBOR CITY BLVD | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | MELBOURNE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 329011966 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3219144211 | ||||||||
| FaxNumber: | 3219144212 | ||||||||
| Practice Location | |||||||||
| Address1: | 1130 S HARBOR CITY BLVD | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | MELBOURNE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 329011966 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3216742114 | ||||||||
| FaxNumber: | 3216742118 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/04/2013 | ||||||||
| LastUpdateDate: | 04/30/2013 | ||||||||
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| AuthorizedOfficialLastName: | ZIPPER | ||||||||
| AuthorizedOfficialFirstName: | RALPH | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3219144211 | ||||||||
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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 | 207VX0000X | ME76190 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Obstetrics |
No ID Information.