Provider Demographics
NPI:1710276464
Name:WARRIER, NISHA PULPET (MD)
Entity Type:Individual
Prefix:
First Name:NISHA
Middle Name:PULPET
Last Name:WARRIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12731 NEW BRITTANY BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-3632
Mailing Address - Country:US
Mailing Address - Phone:239-418-0999
Mailing Address - Fax:239-418-0091
Practice Address - Street 1:12731 NEW BRITTANY BLVD
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-3632
Practice Address - Country:US
Practice Address - Phone:239-418-0999
Practice Address - Fax:239-418-0091
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-04
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME128142207W00000X
MA258800207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017471300Medicaid
FLVSPCWOtherBC BS
FLIP855ZMedicare PIN
FLIP855YMedicare PIN