MEDICARE: JOHNSON MEDICAL SERVICES CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician		FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285871665
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHNSON MEDICAL SERVICES CORPORATION

Provider Business Mailing Address
First Line	:	2531 N DIXIE HWY
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33460-6250
Country	:	US
Telephone Number	:	561-582-0330
Fax Number	:	561-582-0339

Provider Business Practice Location Address
First Line	:	2531 N DIXIE HWY
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33460-6250
Country	:	US
Telephone Number	:	561-582-0330
Fax Number	:	561-582-0339

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. MARIA URBINA
Credential	:
Telephone Number	:	561-582-0330

Provider Enumeration Date	:	01/07/2009
Last Update Date	:	04/10/2021

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Directions to “JOHNSON MEDICAL SERVICES CORPORATION ” Practice Location

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