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Individual
NATHAN R. TIPPER
Active
Individual
NATHAN R. TIPPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
ME157334
FL
207QS0010X
Sports Medicine (Family Medicine) Physician
93640
SC
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
ME157334
FL
390200000X
Student in an Organized Health Care Education/Training Program
4301115789
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114490900
—
FL
Enumeration date
06/20/2018
Last updated
01/15/2025
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