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General NPI Number Information
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NPI Number | 1861697906
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Entity Type | Individual
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Provider Name | SHARON DELORIS ELEASE JOHNSON PA
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Gender | Female
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Dates
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Enumeration Date | 06/19/2007
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 12953 PALMS WEST DR SUITE 202
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City | LOXAHATCHEE
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State | FL
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Zip | 33470-4990
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Country | US
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Telephone | 561-791-7969
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Fax | 561-791-7968
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Provider Business Mailing Address
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Address Line | 1157 S STATE ROAD 7
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City | WELLINGTON
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State | FL
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Zip | 33414-6101
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Country | US
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Telephone | 561-795-3330
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Fax | 561-795-1030
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9103898
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License Number State | FL
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