Individual
DR. MICHAEL SCOTT WILLENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3003 CLAIRE LN 100, JACKSONVILLE, FL 32223-6645
(904) 683-2596
(904) 683-2597
Mailing address
3003 CLAIRE LN 100, JACKSONVILLE, FL 32223-6645
(904) 683-2596
(904) 683-2597
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
OS8432
FL
207LP2900X
Pain Medicine (Anesthesiology) Physician
OS8432
FL
208VP0000X
Pain Medicine Physician
OS8432
FL
208VP0014X
Interventional Pain Medicine Physician
Primary
OS8432
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03193A
MEDICARE ID
FL
Enumeration date
05/10/2006
Last updated
04/17/2024
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