Healthcare Provider Details

I. General information

NPI: 1932187960
Provider Name (Legal Business Name): RONALD BELLE JOHNSTON JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7720 US HIGHWAY 98 W STE 340
MIRAMAR BEACH FL
32550
US

IV. Provider business mailing address

801 YORK ST
MANITOWOC WI
54220-4630
US

V. Phone/Fax

Practice location:
  • Phone: 850-502-5989
  • Fax: 850-266-6301
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberME85301
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberME85301
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: