Healthcare Provider Details

I. General information

NPI: 1194303610
Provider Name (Legal Business Name): LASHEA MONET JOHNSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 07/17/2024
Certification Date: 07/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 N KENDALL DR
MIAMI FL
33176-2118
US

IV. Provider business mailing address

PO BOX 198054
ATLANTA GA
30384-8054
US

V. Phone/Fax

Practice location:
  • Phone: 786-596-6743
  • Fax: 786-533-9711
Mailing address:
  • Phone: 786-594-6880
  • Fax: 786-533-9261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME163596
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: