Healthcare Provider Details

I. General information

NPI: 1801712823
Provider Name (Legal Business Name): JANELLE JOHNSON MPT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9022 NW 47TH CT
CORAL SPRINGS FL
33067-1935
US

IV. Provider business mailing address

6901 E CYPRESSHEAD DR
PARKLAND FL
33067-1610
US

V. Phone/Fax

Practice location:
  • Phone: 954-305-3898
  • Fax: 954-305-3898
Mailing address:
  • Phone: 954-818-5714
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: JANELLE JOHNSON
Title or Position: OWNER
Credential: MPT
Phone: 954-818-5714