Provider Demographics
NPI:1396015228
Name:WARREN, PAUL DREW (MS)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:DREW
Last Name:WARREN
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W NEW HAVEN AVE
Mailing Address - Street 2:APT 201
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-4306
Mailing Address - Country:US
Mailing Address - Phone:407-782-9128
Mailing Address - Fax:
Practice Address - Street 1:640 BREVARD AVE
Practice Address - Street 2:
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32922-7849
Practice Address - Country:US
Practice Address - Phone:321-433-1111
Practice Address - Fax:321-978-0298
Is Sole Proprietor?:No
Enumeration Date:2012-01-10
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator