Healthcare Provider Details

I. General information

NPI: 1275836512
Provider Name (Legal Business Name): LINDA JULIA JOHNSON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2010
Last Update Date: 10/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6141 SUNSET DR STE 401
SOUTH MIAMI FL
33143-5026
US

IV. Provider business mailing address

6141 SUNSET DR STE 401
SOUTH MIAMI FL
33143-5026
US

V. Phone/Fax

Practice location:
  • Phone: 305-667-6511
  • Fax:
Mailing address:
  • Phone: 305-667-4511
  • Fax: 305-667-0411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberARNP3396112
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: