Provider Demographics
NPI:1083191415
Name:WARREN, MYRLENE (BSW, MPA)
Entity Type:Individual
Prefix:MRS
First Name:MYRLENE
Middle Name:
Last Name:WARREN
Suffix:
Gender:F
Credentials:BSW, MPA
Other - Prefix:
Other - First Name:MYRLENE
Other - Middle Name:
Other - Last Name:SAINT AIME
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 S GARLAND AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-3276
Mailing Address - Country:US
Mailing Address - Phone:407-476-9456
Mailing Address - Fax:
Practice Address - Street 1:101 S GARLAND AVE STE 108
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-3276
Practice Address - Country:US
Practice Address - Phone:407-476-9456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-27
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No372600000XNursing Service Related ProvidersAdult Companion