Healthcare Provider Details

I. General information

NPI: 1023206661
Provider Name (Legal Business Name): POONAM WARMAN M D P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2007
Last Update Date: 12/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 SE MAGNOLIA EXT STE 202
OCALA FL
34471-4461
US

IV. Provider business mailing address

1500 SE MAGNOLIA EXT STE 202
OCALA FL
34471-4461
US

V. Phone/Fax

Practice location:
  • Phone: 352-369-6139
  • Fax:
Mailing address:
  • Phone: 352-369-6139
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. POONAM WARMAN
Title or Position: OWNER
Credential: M.D.
Phone: 352-369-6139