Healthcare Provider Details

I. General information

NPI: 1568717163
Provider Name (Legal Business Name): JARED ALEXANDER WARREN DO, ATC, CSCS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2012
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 CLEVELAND CLINIC BLVD
WESTON FL
33331-3625
US

IV. Provider business mailing address

3155 SW 147TH TER # 152
PEMBROKE PINES FL
33027-6263
US

V. Phone/Fax

Practice location:
  • Phone: 216-704-6892
  • Fax:
Mailing address:
  • Phone: 425-301-7914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberOS21935
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: