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General NPI Number Information
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NPI Number | 1740619824
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Entity Type | Organization
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Legal Business Name | DR STEPHANIE L JOHNSON, PA
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Dates
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Enumeration Date | 11/08/2013
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 7749 NORMANDY BLVD STE 121
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City | JACKSONVILLE
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State | FL
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Zip | 32221-7658
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Country | US
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Telephone | 904-237-7997
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Fax | 904-269-9104
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Provider Business Mailing Address
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Address Line | 7749 NORMANDY BLVD STE 121
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City | JACKSONVILLE
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State | FL
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Zip | 32221-7658
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Country | US
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Telephone | 904-237-7997
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Fax | 904-269-9104
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. STEPHANIE L JOHNSON
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Credential | OD
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Telephone | 904-237-7997
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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 | OPC2964
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License Number State | FL
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