MEDICARE: MICHAEL A JOHNSON BCHIS

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	237700000X	Hearing Instrument Specialist	AS3012	FL

General Provider Information

NPI Number	:	1447427281
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL A JOHNSON BCHIS

Provider Business Mailing Address
First Line	:	110 N ORLANDO AVE
Second Line	:	SUITE 7
City	:	MAITLAND
State	:	FL
Zip	:	32751-5574
Country	:	US
Telephone Number	:	407-388-3648
Fax Number	:	407-388-3650

Provider Business Practice Location Address
First Line	:	110 N ORLANDO AVE
Second Line	:	SUITE 7
City	:	MAITLAND
State	:	FL
Zip	:	32751-5574
Country	:	US
Telephone Number	:	407-388-3648
Fax Number	:	407-388-3650

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

Provider Enumeration Date	:	05/12/2008
Last Update Date	:	05/12/2008

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