Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 12982 | FL |
Y | 213EG0000X | General Practice | 12982 | FL |
N | 1223G0001X | General Practice | DN0012982 | FL |
N | 213EG0000X | General Practice | DN0012982 | FL |
NPI | 1003904400 |
---|---|
Provider Name | Dr. Corey Greg Warrenbrand |
First Address | Sarasota, FL 34231 |
Second Address | Sarasota, FL 34231 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 14/08/2018 |