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General NPI Number Information
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NPI Number | 1912262544
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Entity Type | Organization
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Legal Business Name | INJURY MANAGEMENT, LLC
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Dates
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Enumeration Date | 07/10/2012
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Last Update Date | 07/10/2012
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Provider Practice Location Address
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Address Line | 4010 NW 100TH AVE
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-1549
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Country | US
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Telephone | 954-298-4015
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Fax | 954-341-9772
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Provider Business Mailing Address
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Address Line | 4010 NW 100TH AVE
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-1549
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. JUDITH MITCHELL JOHNSON
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Credential | M.D.
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Telephone | 954-298-4015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | ME043407
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License Number State | FL
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