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NPI Code Detail

MEDICARE: MRS. CASSANDRA NICHOLE WARNER APRN

MEDICARE: MRS. CASSANDRA NICHOLE WARNER APRN
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
1363LF0000XFamily Nurse Practitioner11016401FL

General Provider Information

NPI Number : 1124787742
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CASSANDRA NICHOLE WARNER APRN
Provider Business Mailing Address
First Line : 6101 BLUE LAGOON DR STE 200
Second Line :
City : MIAMI
State : FL
Zip : 33126-3168
Country : US
Telephone Number : 305-500-2000
Fax Number :
Provider Business Practice Location Address
First Line : 4090 S RIDGEWOOD AVE
Second Line :
City : PORT ORANGE
State : FL
Zip : 32127-4501
Country : US
Telephone Number : 386-761-0050
Fax Number : 386-761-1167
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2021
Last Update Date : 01/16/2025

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Directions to “ MRS. CASSANDRA NICHOLE WARNER APRN” Practice Location

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