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General NPI Number Information
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NPI Number | 1295071579
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Entity Type | Individual
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Provider Name | MARK DAVID JOHNSON HSA
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Gender | Male
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Dates
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Enumeration Date | 12/14/2012
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Last Update Date | 09/13/2018
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Provider Practice Location Address
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Address Line | 1008 WILLA SPRINGS DR STE 110
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City | WINTER SPRINGS
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State | FL
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Zip | 32708-5205
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Country | US
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Telephone | 407-637-5891
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Fax | 407-636-6205
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Provider Business Mailing Address
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Address Line | 1008 WILLA SPRINGS DR STE 110
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City | WINTER SPRINGS
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State | FL
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Zip | 32708-5205
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Country | US
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Telephone | 407-637-5891
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Fax | 407-636-6205
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | AS2511
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License Number State | FL
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