Healthcare Provider Details

I. General information

NPI: 1548189533
Provider Name (Legal Business Name): VICTORIA DENISE JOHNSON-MCDUFFIE FNP-C & FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11755 FOXBRIAR LAKE TRL
BOYNTON BEACH FL
33473-7829
US

IV. Provider business mailing address

11755 FOXBRIAR LAKE TRL
BOYNTON BEACH FL
33473-7829
US

V. Phone/Fax

Practice location:
  • Phone: 954-914-4157
  • Fax:
Mailing address:
  • Phone: 954-914-4157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11049128
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: