Basic Information
| Provider Information | |||||||||
| NPI: | 1801154794 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WARMOTH | ||||||||
| FirstName: | ASHLEY | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12545 NEW BRITTANY BLVD STE 26 | ||||||||
| Address2: | |||||||||
| City: | FORT MYERS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339073625 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2392742071 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 12545 NEW BRITTANY BLVD STE 26 | ||||||||
| Address2: | |||||||||
| City: | FORT MYERS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339073625 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2392742071 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/27/2012 | ||||||||
| LastUpdateDate: | 01/29/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | OS15865 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.