Individual
SUJATA TIPNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
(305) 585-7755
(305) 585-8257
Mailing address
1611 NW 12TH AVE, MIAMI, FL 33136-1005
(305) 585-7755
(305) 585-8257
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
C52315
CA
208000000X
Pediatrics Physician
Primary
ME93101
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
273047200
—
FL
Enumeration date
12/22/2005
Last updated
02/17/2015
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