MEDICARE: DR. WARREN JAY STREISAND MD

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	208800000X	Urology Physician	ME19696	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164404182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WARREN JAY STREISAND MD

Provider Business Mailing Address
First Line	:	7421 UNIVERSITY DRIVE
Second Line	:	SUITE 106
City	:	TAMARAC
State	:	FL
Zip	:	33321-2952
Country	:	US
Telephone Number	:	954-722-0150
Fax Number	:	954-722-0188

Provider Business Practice Location Address
First Line	:	7421 UNIVERSITY DRIVE
Second Line	:	SUITE 106
City	:	TAMARAC
State	:	FL
Zip	:	33321-2952
Country	:	US
Telephone Number	:	954-722-0150
Fax Number	:	954-722-0188

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2005
Last Update Date	:	02/07/2014

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