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General NPI Number Information
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NPI Number | 1003605791
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Entity Type | Individual
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Provider Name | JASMINE JOHNSON
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Gender | Female
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Dates
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Enumeration Date | 05/01/2025
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 2906 S FALKENBURG RD
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City | RIVERVIEW
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State | FL
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Zip | 33578-2554
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Country | US
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Telephone | 877-276-0626
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Fax |
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Provider Business Mailing Address
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Address Line | 3520 CLEVELAND HEIGHTS BLVD APT 204
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City | LAKELAND
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State | FL
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Zip | 33803-4952
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Country | US
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Telephone | 863-243-8364
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-25-462437
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License Number State | FL
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