Healthcare Provider Details

I. General information

NPI: 1841272663
Provider Name (Legal Business Name): STEVEN B WARREN MEDICAL DOCTOR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2005
Last Update Date: 04/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4820 PARK BLVD N
PINELLAS PARK FL
33781-3534
US

IV. Provider business mailing address

6500 66TH ST
PINELLAS PARK FL
33781-5030
US

V. Phone/Fax

Practice location:
  • Phone: 727-209-6677
  • Fax:
Mailing address:
  • Phone: 727-347-1286
  • Fax: 727-345-3084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberME60200
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: