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General NPI Number Information
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NPI Number | 1124242367
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Entity Type | Individual
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Provider Name | MICHAEL J. WARNER PSY.D
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Gender | Male
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 04/22/2019
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Provider Practice Location Address
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Address Line | 505 SE 6TH AVE
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-4921
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Country | US
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Telephone | 561-347-1939
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Fax | 561-347-2399
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Provider Business Mailing Address
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Address Line | PO BOX 110520
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City | PALM BAY
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State | FL
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Zip | 32911-0520
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Country | US
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Telephone | 561-347-1939
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Fax | 561-347-2399
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY0003679
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License Number State | FL
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