Provider Demographics
NPI:1679560130
Name:WARREN, LESLEY ANNE (DPM)
Entity Type:Individual
Prefix:
First Name:LESLEY
Middle Name:ANNE
Last Name:WARREN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:333 ARTHUR GODFREY RD
Mailing Address - Street 2:SUITE 718
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3608
Mailing Address - Country:US
Mailing Address - Phone:305-531-5446
Mailing Address - Fax:305-531-6170
Practice Address - Street 1:333 ARTHUR GODFREY RD
Practice Address - Street 2:SUITE 718
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3608
Practice Address - Country:US
Practice Address - Phone:305-531-5446
Practice Address - Fax:305-531-6170
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO002466213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4695260001Medicare NSC