MEDICARE: DR. CHRISTOPHER W. JOHNSON, D.P.M., PA

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	332B00000X	Durable Medical Equipment & Medical Supplies	PO2947	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1043383037	OTHER	FL	NPI

General Provider Information

NPI Number	:	1356511430
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER W. JOHNSON, D.P.M., PA

Provider Business Mailing Address
First Line	:	5640 FARRAGUT ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-2721
Country	:	US
Telephone Number	:	954-986-1090
Fax Number	:	954-894-9093

Provider Business Practice Location Address
First Line	:	5640 FARRAGUT ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-2721
Country	:	US
Telephone Number	:	954-986-1090
Fax Number	:	954-894-9093

Authorized Official
Title or Position	:	DIRECT OWNER
Name	:	DR. CHRISTOPHER W. JOHNSON
Credential	:	D.P.M.
Telephone Number	:	954-986-1090

Provider Enumeration Date	:	03/05/2008
Last Update Date	:	03/07/2023

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