Healthcare Provider Details

I. General information

NPI: 1124094610
Provider Name (Legal Business Name): WARREN M STURMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 04/01/2024
Certification Date: 04/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 SE 3RD AVE STE 721
FORT LAUDERDALE FL
33316-2521
US

IV. Provider business mailing address

1700 NW 49TH ST STE 125
FORT LAUDERDALE FL
33309-3750
US

V. Phone/Fax

Practice location:
  • Phone: 954-355-4617
  • Fax: 954-355-4618
Mailing address:
  • Phone: 954-355-4617
  • Fax: 954-355-4618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME0047084
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: