MEDICARE: WARREN V CARRIGAN III MD

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	2084N0400X	Neurology Physician	ME107691	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P01233477	OTHER	FL	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326282153
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WARREN V CARRIGAN III MD

Provider Business Mailing Address
First Line	:	PO BOX 49237
Second Line	:
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32240-9237
Country	:	US
Telephone Number	:	904-860-3761
Fax Number	:	888-533-3178

Provider Business Practice Location Address
First Line	:	632 MAGNOLIA ST
Second Line	:
City	:	NEPTUNE BEACH
State	:	FL
Zip	:	32266-3734
Country	:	US
Telephone Number	:	904-860-3761
Fax Number	:	904-249-9764

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

Provider Enumeration Date	:	04/23/2009
Last Update Date	:	07/18/2025

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