Provider Demographics
NPI:1770840407
Name:WARREN, SANDRA MARCELA (MD)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:MARCELA
Last Name:WARREN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:SANDRA
Other - Middle Name:MARCELA
Other - Last Name:FORERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:13643 ISHNALA CIR
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-7804
Mailing Address - Country:US
Mailing Address - Phone:561-758-8284
Mailing Address - Fax:
Practice Address - Street 1:7408 LAKE WORTH RD
Practice Address - Street 2:SUITE 700
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-2502
Practice Address - Country:US
Practice Address - Phone:561-370-1320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-19
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1230452083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine