Provider Demographics
NPI:1902141773
Name:LIPPMANN, BENJAMIN ELLIOT (DO)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:ELLIOT
Last Name:LIPPMANN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5302 S FLORIDA AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-4910
Mailing Address - Country:US
Mailing Address - Phone:863-289-0968
Mailing Address - Fax:863-228-8532
Practice Address - Street 1:5302 S FLORIDA AVE STE 206
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-4910
Practice Address - Country:US
Practice Address - Phone:863-289-0968
Practice Address - Fax:863-228-8532
Is Sole Proprietor?:No
Enumeration Date:2012-12-05
Last Update Date:2022-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS126822084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry