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General NPI Number Information
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NPI Number | 1457460396
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Entity Type | Individual
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Provider Name | MARK G WARREN D.P.M
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Gender | Male
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 07/25/2013
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Provider Practice Location Address
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Address Line | 1325 S CONGRESS AVE SUITE 108
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-5876
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Country | US
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Telephone | 561-369-3300
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Fax | 561-734-2811
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Provider Business Mailing Address
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Address Line | 821 S.W. 36TH AVE
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City | BOYNTON BEACH
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State | FL
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Zip | 33435
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Country | US
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Telephone | 561-369-3300
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Fax | 561-734-2811
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | PO1194
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License Number State | FL
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