Healthcare Provider Details

I. General information

NPI: 1760302806
Provider Name (Legal Business Name): CHRISTABEL GRACE JOHNSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5324 LITTLE RD
NEW PORT RICHEY FL
34655-1294
US

IV. Provider business mailing address

1814 ARTURUS LN
TRINITY FL
34655-4930
US

V. Phone/Fax

Practice location:
  • Phone: 727-375-5383
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS70958
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: