Individual
PEDRO C LIPPA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1900 BROTHER GEENEN WAY, SARASOTA, FL 34236-7102
(941) 566-3220
(941) 955-8214
Mailing address
1888 BROTHER GEENEN WAY, SARASOTA, FL 34236-7118
(941) 566-3220
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME74494
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13485
BLUE CROSS/BLUE SHIELD
FL
05
—
263073700
—
FL
01
—
E66212T
MEDICARE
FL
01
—
P00077861
RAILROAD MEDICARE
—
Enumeration date
12/01/2005
Last updated
08/15/2019
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