Healthcare Provider Details

I. General information

NPI: 1871508549
Provider Name (Legal Business Name): POONAM WARMAN MD PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 04/29/2022
Certification Date: 04/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 SE MAGNOLIA EXT SUITE 202
OCALA FL
34471-4463
US

IV. Provider business mailing address

PO BOX 2017
OCALA FL
34478-2017
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 TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberME69632
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberME69632
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME69632
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: