Provider Demographics
NPI:1396997185
Name:SCHIRRIPA, ANTHONY DOMINICK (MD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:DOMINICK
Last Name:SCHIRRIPA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 411307
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32941-1307
Mailing Address - Country:US
Mailing Address - Phone:321-226-8607
Mailing Address - Fax:
Practice Address - Street 1:3040 N WICKHAM RD
Practice Address - Street 2:SUITE 6
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935
Practice Address - Country:US
Practice Address - Phone:321-226-8607
Practice Address - Fax:718-816-3115
Is Sole Proprietor?:No
Enumeration Date:2008-10-13
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME117950207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02241803Medicaid
NYA400005057Medicare PIN