MEDICARE: BRAD J WARONICKI, O.D., P.A.

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	152W00000X	Optometrist	OPC 2404	FL
2	156FX1800X	Optician	DO 2488	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	49671	OTHER	FL	DAVIS VISION
2	20272	OTHER	FL	20272
3	168	OTHER	FL	METCARE

General Provider Information

NPI Number	:	1205955663
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRAD J WARONICKI, O.D., P.A.

Provider Business Mailing Address
First Line	:	2626 SE WILLOUGHBY BLVD
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34994-4700
Country	:	US
Telephone Number	:	772-286-4878
Fax Number	:	772-286-4368

Provider Business Practice Location Address
First Line	:	2626 SE WILLOUGHBY BLVD
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34994-4700
Country	:	US
Telephone Number	:	772-286-4878
Fax Number	:	772-286-4368

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BRAD J WARONICKI
Credential	:	O.D.
Telephone Number	:	772-286-4878

Provider Enumeration Date	:	03/28/2007
Last Update Date	:	09/11/2025

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