Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | ME141495 | FL |
NPI | 1033556634 |
---|---|
Provider Name | Brittany N Warren |
First Address | Orlando, FL 32806-1122 |
Second Address | Orlando, FL 32806-1122 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2013 |
Last Update Date | 18/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
103418300 | (05) | FL |