Provider Demographics
NPI:1306465968
Name:PHIPPS, RONALD
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:PHIPPS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 S SEMORAN BLVD
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-5313
Mailing Address - Country:US
Mailing Address - Phone:888-830-1051
Mailing Address - Fax:
Practice Address - Street 1:925 S SEMORAN BLVD
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-5313
Practice Address - Country:US
Practice Address - Phone:888-830-1051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-14
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX733922279E0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2279E0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredEmergency CareGroup - Single Specialty