Healthcare Provider Details

I. General information

NPI: 1124089842
Provider Name (Legal Business Name): JOHN MICHAEL HURCHIK DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5841 ARGERIAN DR STE 102
WESLEY CHAPEL FL
33545-4505
US

IV. Provider business mailing address

5841 ARGERIAN DR STE 102
WESLEY CHAPEL FL
33545-4505
US

V. Phone/Fax

Practice location:
  • Phone: 813-788-1006
  • Fax: 407-671-4155
Mailing address:
  • Phone: 813-788-1006
  • Fax: 407-671-4155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ER0200X
TaxonomyRadiology Podiatrist
License NumberPO3515
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License NumberPO3515
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO3515
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: