Healthcare Provider Details

I. General information

NPI: 1821245424
Provider Name (Legal Business Name): RANDALL JAMES WARREN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2008
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 CORTARO DR DEPT OF ANESTHESIOLOGY, VAMC
SUN CITY CENTER FL
33573-3357
US

IV. Provider business mailing address

720 CORTARO DR
SUN CITY CENTER FL
33573-6811
US

V. Phone/Fax

Practice location:
  • Phone: 833-320-7246
  • Fax: 833-282-8899
Mailing address:
  • Phone: 833-320-7426
  • Fax: 833-282-8899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberME108567
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number4301088532
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: