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General NPI Number Information
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NPI Number | 1164744298
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Entity Type | Individual
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Provider Name | TAMIKA T. JOHNSON LMT
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Gender | Female
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Dates
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Enumeration Date | 02/16/2010
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Last Update Date | 02/16/2010
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Provider Practice Location Address
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Address Line | 5924 RIVERSIDE AVE
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City | TAMARAC
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State | FL
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Zip | 33321-4107
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Country | US
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Telephone | 954-478-4883
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Fax |
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Provider Business Mailing Address
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Address Line | 5924 RIVERSIDE AVE
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City | TAMARAC
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State | FL
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Zip | 33321-4107
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Country | US
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Telephone | 954-478-4883
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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 | 175L00000X
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Taxonomy Name | Homeopath
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License Number | MA31371
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License Number State | FL
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