Provider Demographics
NPI:1407056161
Name:WARBURTON FREY & ASSOCIATES P A
Entity Type:Organization
Organization Name:WARBURTON FREY & ASSOCIATES P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:WARBURTON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:561-351-5445
Mailing Address - Street 1:210 NW PLEASANT GROVE WAY
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-3584
Mailing Address - Country:US
Mailing Address - Phone:561-351-5445
Mailing Address - Fax:
Practice Address - Street 1:2144 W INDIANTOWN RD
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-5810
Practice Address - Country:US
Practice Address - Phone:561-351-5445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-20
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty