MEDICARE: IRA G WARSHAW MDPA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	ME64974	FL

General Provider Information

NPI Number	:	1053500702
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IRA G WARSHAW MDPA

Provider Business Mailing Address
First Line	:	1216 US HIGHWAY 1
Second Line	:	SUITE A
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-3537
Country	:	US
Telephone Number	:	561-626-1000
Fax Number	:	561-630-5388

Provider Business Practice Location Address
First Line	:	1216 US HIGHWAY 1
Second Line	:	SUITE A
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-3537
Country	:	US
Telephone Number	:	561-626-1000
Fax Number	:	561-630-5388

Authorized Official
Title or Position	:	PRESIDENT
Name	:	IRA G WARSHAW
Credential	:	MDPA
Telephone Number	:	561-626-1000

Provider Enumeration Date	:	10/18/2007
Last Update Date	:	05/16/2008

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