MEDICARE: DR. MICHAEL WARHURST D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208VP0014X	Interventional Pain Medicine Physician	OS15959	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	UO5244	OTHER	FL	FLORIDA TRAINING LICENSE NUMBER

General Provider Information

NPI Number	:	1356791743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL WARHURST D.O.

Provider Business Mailing Address
First Line	:	15496 MAX LEGGETT PKWY
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32218-2564
Country	:	US
Telephone Number	:	904-895-5400
Fax Number	:	904-895-5401

Provider Business Practice Location Address
First Line	:	2320 3RD ST S STE 12
Second Line	:
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-4057
Country	:	US
Telephone Number	:	904-568-6116
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2016
Last Update Date	:	03/17/2026

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