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NPI Code Detail

MEDICARE: DR STEPHANIE L JOHNSON, PA

MEDICARE: DR STEPHANIE L JOHNSON, PA
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
1152W00000XOptometristOPC2964FL

General Provider Information

NPI Number : 1740619824
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR STEPHANIE L JOHNSON, PA
Provider Business Mailing Address
First Line : 7749 NORMANDY BLVD STE 121
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32221-7658
Country : US
Telephone Number : 904-237-7997
Fax Number : 904-269-9104
Provider Business Practice Location Address
First Line : 7749 NORMANDY BLVD STE 121
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32221-7658
Country : US
Telephone Number : 904-237-7997
Fax Number : 904-269-9104
Authorized Official
Title or Position : OPTOMETRIST
Name : DR. STEPHANIE L JOHNSON
Credential : OD
Telephone Number : 904-237-7997
Provider Enumeration Date : 11/08/2013
Last Update Date : 04/17/2025

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