Individual
LARRY J KIPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
5145 DEER PARK DR, NEW PORT RICHEY, FL 34653-7013
(727) 847-2406
(855) 552-3776
Mailing address
7211 N DALE MABRY HWY STE 100, TAMPA, FL 33614-2669
(727) 847-2406
(727) 841-0567
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
P0000655
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00414977
RAILROAD MEDICARE
FL
Enumeration date
08/22/2006
Last updated
11/12/2018
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