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General NPI Number Information
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NPI Number | 1770840407
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Entity Type | Individual
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Provider Name | SANDRA MARCELA WARREN M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/19/2012
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Last Update Date | 06/21/2016
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Provider Practice Location Address
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Address Line | 7408 LAKE WORTH RD SUITE 700
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City | LAKE WORTH
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State | FL
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Zip | 33467-2502
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Country | US
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Telephone | 561-370-1320
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Fax |
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Provider Business Mailing Address
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Address Line | 13643 ISHNALA CIR
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City | WELLINGTON
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State | FL
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Zip | 33414-7804
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Country | US
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Telephone | 561-758-8284
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Fax |
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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 | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | ME123045
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License Number State | FL
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