MR. WARREN RANDALL SUMNER (NPI# 1609866219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609866219 |
| Entity Type | Individual |
| Full Name | MR. WARREN RANDALL SUMNER |
| Credential | PA-C |
| Practice Address |
3003 W Dr Martin Luther King Jr Blvd Mab 2nd Floor Tampa FL 33607-6307 |
| Mailing Address |
Po Box 10744 Clearwater FL 33757-8744 |
| Practice Telephone | 8133216580 |
| Practice Fax Number | 8134438185 |
| Mailing Telephone | 7275320002 |
| Mailing Fax Number | 7272664943 |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2016-08-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 003541 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA9108734 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
003541 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | WELLCARE | 404215 | 01 |
| GA | RR MEDICARE | P00679501 | 01 |
| GA | 100001160D | 05 | |
| GA | AMERIGROUP | 01067693 | 01 |
| FL | 015768600 | 05 | |
| SC | 0155PA | 05 |
| Street Address |
3003 W DR MARTIN LUTHER KING JR BLVD MAB 2ND FLOOR |
| City | TAMPA |
| State | FL |
| Zip Code | 33607-6307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790282036 | Candice Sharee Hardee | Nurse Practitioner | 3003 W Dr Martin Luther King Jr Blvd, Tampa, FL 33607-6307 | 2018-04-12 |
| 1992217293 | Meby S Abraham | Pharmacist | 3003 W Dr Martin Luther King Jr Blvd, Tampa, FL 33607-6307 | 2017-10-26 |
| 1770018988 | Publix Super Markets Inc | Durable Medical Equipment & Medical Supplies | 3003 W Dr Martin Luther King Jr Blvd, Tampa, FL 33607-6307 | 2017-04-25 |
| 1336523968 | Gary J Kuznicki | Physician Assistant | 3003 W Dr Martin Luther King Jr Blvd, Mab-3rd Floor, Tampa, FL 33607-6307 | 2015-07-14 |
| 1932591021 | Lauren Michelle Smith | Nurse Practitioner | 3003 W Dr Martin Luther King Jr Blvd, 2nd Floor Mab, Tampa, FL 33607-6307 | 2015-02-26 |
| 1639573512 | John-colby Carter | Physician Assistant | 3003 W Dr Martin Luther King Jr Blvd, Mab 2nd Floor, Tampa, FL 33607-6307 | 2014-10-21 |
| 1427459163 | Samit Patel | Pediatrics | 3003 W Dr Martin Luther King Jr Blvd, Tampa, FL 33607-6307 | 2014-09-12 |
| 1487078903 | Dawn Elizabeth Stone | Nurse Practitioner | 3003 W Dr Martin Luther King Jr Blvd, Mab 3rd Floor, Tampa, FL 33607-6307 | 2014-02-05 |
| 1679901151 | Chelsea N. Cronin | Physician Assistant | 3003 W Dr Martin Luther King Jr Blvd, 2nd Floor Mab, Tampa, FL 33607 | 2013-10-22 |
| 1982039731 | Baycare Home Care Inc | Pharmacy | 3003 W Dr Martin Luther King Jr Blvd, Tampa, FL 33607-6307 | 2013-09-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326656265 | Sky City Pharmacy LLC | Pharmacy | 2812 W. Dr Martin Luther King Jr Blvd, Tampa, FL 33607 | 2020-07-16 |
| 1821614413 | Tammy Sue Alleyn | Social Worker | 4414 N. Armenia Av., Tampa, FL 33607 | 2020-06-19 |
| 1912528290 | Advanced Mobile Medical Services | Clinic/Center | 2136 W. Mlk Blvd, Tampa, FL 33607 | 2020-04-28 |
| 1659909232 | Rachel Sobiech | Social Worker | 2006 Pan Am Circle, Suite 270, Tampa, FL 33607 | 2020-03-30 |
| 1295379733 | Melizza Liz Sanchez Ayala | Registered Nurse | 1701 N Lois Avenue, Valera Apt Unit 224, Tampa, FL 33607 | 2019-10-28 |
| 1720647191 | Caretyme LLC | Clinic/Center | 1923 West St. John Street, Tampa, FL 33607 | 2019-06-10 |
| 1720545981 | Amante Medical and Diabetic Center, P.a. | Internal Medicine | 1001 N Macdill Ave. Suite B, Tampa, FL 33607 | 2019-02-25 |
| 1609360908 | Misty Dawn Ray Ross | Social Worker | 2902 N Armenia Ave Ste 200, Tampa, FL 33607 | 2018-06-20 |
| 1255825154 | Kenneth Konrad Schirer | Physical Therapist | 2700 W Dr. Mlk Blvd, Suite 300, Tampa, FL 33607 | 2018-06-14 |
| 1902314875 | Cardiac Cin of Florida, LLC | Internal Medicine | 3001 W Martin Luther King Jr Blvd, Tampa, FL 33607 | 2018-01-13 |
| Find all providers in zip 33607 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508377219 | Hansel David Baez | Physician Assistant | 10740 Palm River Rd Ste 300, Tampa, FL 33619-4577 | 2017-10-20 |
| 1972502714 | Cynthia B Anders | Physician Assistant | 12880 Commodity Pl, Tampa, FL 33626-3101 | 2005-07-14 |
| 1144783630 | Rachel Tipton | Physician Assistant | 909 N Dale Mabry Hwy, Tampa, FL 33609-1251 | 2019-04-11 |
| 1275022618 | Samantha Anna Wloch | Physician Assistant | 12902 Usf Magnolia Dr, Tampa, FL 33612-9416 | 2018-05-01 |
| 1154825537 | Seth Lloyd | Physician Assistant | 10740 Palm River Rd Ste 300, Tampa, FL 33619-4577 | 2018-03-21 |
| 1649782384 | Riley Harms | Physician Assistant | 10740 Palm River Rd Ste 300, Tampa, FL 33619-4577 | 2017-11-03 |
| 1982137824 | Chris Taylor | Physician Assistant | 3000 Medical Park Dr, Ste 500, Tampa, FL 33613-4680 | 2017-04-07 |
| 1184157174 | Maya Niewiadomska | Physician Assistant | 2 Tampa General Cir, Tampa, FL 33606-3603 | 2017-04-06 |
| 1720537921 | Paolo Calizo | Physician Assistant | 3003 W Dr Martin Luther King Jr Blvd Fl 2, Tampa, FL 33607 | 2016-09-28 |
| 1104293380 | Vc-pa First Assist, LLC | Physician Assistant | 10006 Cross Creek Blvd, #449, Tampa, FL 33647-2595 | 2015-08-24 |
| Find all providers in TAMPA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.