Healthcare Provider Details
I. General information
NPI: 1730447400
Provider Name (Legal Business Name): JOHONNA GILBREATH ASQUITH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/01/2012
Last Update Date: 06/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14690 SPRING HILL DR STE 206
SPRING HILL FL
34609
US
IV. Provider business mailing address
14690 SPRING HILL DR STE 305
SPRING HILL FL
34609-8102
US
V. Phone/Fax
- Phone: 352-799-4206
- Fax: 352-799-4207
- Phone: 352-277-5348
- Fax: 352-606-2857
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RI0200X |
| Taxonomy | Infectious Disease Physician |
| License Number | ME132589 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: