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General NPI Number Information
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NPI Number | 1205955663
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Entity Type | Organization
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Legal Business Name | BRAD J WARONICKI, O.D., P.A.
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2626 SE WILLOUGHBY BLVD
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City | STUART
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State | FL
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Zip | 34994-4700
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Country | US
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Telephone | 772-286-4878
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Fax | 772-286-4368
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Provider Business Mailing Address
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Address Line | 2626 SE WILLOUGHBY BLVD
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City | STUART
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State | FL
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Zip | 34994-4700
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Country | US
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Telephone | 772-286-4878
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Fax | 772-286-4368
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRAD J WARONICKI
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Credential | O.D.
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Telephone | 772-286-4878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC 2404
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | DO 2488
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License Number State | FL
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