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NPI Code Detail

MEDICARE: MR. CHRISTOPHER L JOHNSON PA-C

MEDICARE:  MR. CHRISTOPHER L JOHNSON  PA-C
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
1363AM0700XMedical Physician AssistantPA9110531FL

Other Identifiers

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

General Provider Information

NPI Number : 1497158083
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CHRISTOPHER L JOHNSON PA-C
Provider Business Mailing Address
First Line : 5845 WINTER GARDEN VINELAND RD
Second Line :
City : WINDERMERE
State : FL
Zip : 34786-6124
Country : US
Telephone Number : 407-203-1682
Fax Number :
Provider Business Practice Location Address
First Line : 5845 WINTER GARDEN VINELAND RD
Second Line :
City : WINDERMERE
State : FL
Zip : 34786-6124
Country : US
Telephone Number : 407-203-1682
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2014
Last Update Date : 07/12/2024

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Directions to “ MR. CHRISTOPHER L JOHNSON PA-C” Practice Location

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