Organization Name: | NEIL J WARREN DPM PA |
NPI Number: | 1023048063 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | NEIL JAY WARREN (OWNER) |
Mailing Address: | 428 E Lake Dr Sarasota |
State: | FL US |
Postal Code: | 342321918 |
Phone Number: | 9419061050 |
Fax Number: | 9419061049 |
NPI Enumeration Date: | 07/04/2006 |
NPI Last Update Date: | 04/22/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213EP1101X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Primary Podiatric Medicine |
Taxonomy Definition: |