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NPI Code Detail

MEDICARE: DEVONTE JOHNSON

MEDICARE: DEVONTE JOHNSON
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
1376K00000XNurse's AideCNA380499FL

General Provider Information

NPI Number : 1417612722
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEVONTE JOHNSON
Provider Business Mailing Address
First Line : 7203 SW 44TH PL APT 8
Second Line :
City : GAINESVILLE
State : FL
Zip : 32608-3777
Country : US
Telephone Number : 352-949-0632
Fax Number :
Provider Business Practice Location Address
First Line : 7203 SW 44TH PL APT 8
Second Line :
City : GAINESVILLE
State : FL
Zip : 32608-3777
Country : US
Telephone Number : 352-949-0632
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2021
Last Update Date : 11/02/2021

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Directions to “ DEVONTE JOHNSON ” Practice Location

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