MEDICARE: TZIPORA S JOHNSON RNFA

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	163WR0006X	Registered Nurse First Assistant	RN1979802	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	:	1497809644
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TZIPORA S JOHNSON RNFA

Provider Business Mailing Address
First Line	:	10278 WELLHOUSE CT
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32220-1351
Country	:	US
Telephone Number	:	954-383-5742
Fax Number	:	904-786-1164

Provider Business Practice Location Address
First Line	:	10278 WELLHOUSE CT
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32220-1351
Country	:	US
Telephone Number	:	954-383-5742
Fax Number	:	904-786-1164

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	05/11/2016

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