Provider Demographics
NPI:1316934474
Name:SANDLER, WARREN J (PHD)
Entity type:Individual
Prefix:
First Name:WARREN
Middle Name:J
Last Name:SANDLER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 W PALMETTO PARK RD
Mailing Address - Street 2:STE 210
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3424
Mailing Address - Country:US
Mailing Address - Phone:561-703-0175
Mailing Address - Fax:
Practice Address - Street 1:7000 W PALMETTO PARK RD
Practice Address - Street 2:STE 210
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3424
Practice Address - Country:US
Practice Address - Phone:561-703-0175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-04
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY2917103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL75074Medicare ID - Type Unspecified