MEDICARE: FRANCIS L JOHNSON III

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	2255A2300X	Athletic Trainer

General Provider Information

NPI Number	:	1760016489
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANCIS L JOHNSON III

Provider Business Mailing Address
First Line	:	1226 SMOKE RISE LN
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32317-7106
Country	:	US
Telephone Number	:	850-519-7700
Fax Number	:

Provider Business Practice Location Address
First Line	:	7201 SHELDON RD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-2328
Country	:	US
Telephone Number	:	850-519-7700
Fax Number	:

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

Provider Enumeration Date	:	03/03/2020
Last Update Date	:	03/03/2020

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