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General NPI Number Information
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NPI Number | 1801066188
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Entity Type | Organization
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Legal Business Name | MARK G WARREN D P M P A
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Dates
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Enumeration Date | 03/03/2008
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Last Update Date | 09/09/2021
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Provider Practice Location Address
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Address Line | 5130 LINTON BLVD STE D3
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City | DELRAY BEACH
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State | FL
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Zip | 33484-6595
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Country | US
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Telephone | 561-715-3106
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Fax | 561-336-4245
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Provider Business Mailing Address
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Address Line | 821 SW 36TH AVE
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-8514
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Country | US
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Telephone | 561-715-3106
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Fax | 561-336-4245
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Authorized Official
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Title or Position | OWNER
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Name | MARK G WARREN
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Credential | DPM
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Telephone | 561-715-3106
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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 | PO 1194
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License Number State | FL
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