Provider Demographics
NPI:1467439950
Name:WARSHAW, IRA G (MDPA)
Entity Type:Individual
Prefix:
First Name:IRA
Middle Name:G
Last Name:WARSHAW
Suffix:
Gender:M
Credentials:MDPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1216 US HIGHWAY 1
Mailing Address - Street 2:SUITE A
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-3537
Mailing Address - Country:US
Mailing Address - Phone:561-626-1000
Mailing Address - Fax:561-626-3007
Practice Address - Street 1:1216 US HIGHWAY 1
Practice Address - Street 2:SUITE A
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-3537
Practice Address - Country:US
Practice Address - Phone:561-626-1000
Practice Address - Fax:561-626-3007
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME64974207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL374258000Medicaid
FLCJ5818OtherMEDICARE RAILROAD
FLCJ5818OtherMEDICARE RAILROAD