Healthcare Provider Details

I. General information

NPI: 1851080329
Provider Name (Legal Business Name): RAYMONDA SHEKENYA JOHNSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2023
Last Update Date: 05/02/2023
Certification Date: 05/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7380 W SAND LAKE RD STE 500
ORLANDO FL
32819-5257
US

IV. Provider business mailing address

2881 SANDHILL RIDGE CT APT 317
KISSIMMEE FL
34741-7453
US

V. Phone/Fax

Practice location:
  • Phone: 863-605-5354
  • Fax:
Mailing address:
  • Phone: 863-605-5354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License NumberRN9500478
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN9500478
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN9500478
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN9500478
License Number StateFL
# 5
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN9500478
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: