Healthcare Provider Details

I. General information

NPI: 1013407709
Provider Name (Legal Business Name): HEATHER MORGAN JOHNSON DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2018
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6021 142ND AVE N
CLEARWATER FL
33760-2822
US

IV. Provider business mailing address

1941 DIAMOND HEAD CIR
HAINES CITY FL
33844-1555
US

V. Phone/Fax

Practice location:
  • Phone: 727-796-6900
  • Fax:
Mailing address:
  • Phone: 239-823-0946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberACADEMIC
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO4745
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: