Healthcare Provider Details

I. General information

NPI: 1801722871
Provider Name (Legal Business Name): CASEY WARREN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4414 PEREGRINE WAY APT 308
LAKE WORTH FL
33463-7546
US

IV. Provider business mailing address

4414 PEREGRINE WAY APT 308
LAKE WORTH FL
33463-7546
US

V. Phone/Fax

Practice location:
  • Phone: 954-395-5031
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT26781
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: