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General NPI Number Information
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NPI Number | 1245496538
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Entity Type | Individual
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Provider Name | SARAH A JOHNSON O.D.
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Gender | Female
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Dates
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Enumeration Date | 08/06/2008
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 15661 SAN CARLOS BLVD UNIT 4
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City | FORT MYERS
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State | FL
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Zip | 33908-2797
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Country | US
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Telephone | 239-887-3187
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Fax |
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Provider Business Mailing Address
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Address Line | 1360 E VENICE AVE
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City | VENICE
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State | FL
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Zip | 34285-9066
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Country | US
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Telephone | 941-480-2135
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC4329
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG004312
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1513
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License Number State | NH
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