MEDICARE: LATRICIA JOHNS

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	174H00000X	Health Educator

General Provider Information

NPI Number	:	1760890107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATRICIA JOHNS

Provider Business Mailing Address
First Line	:	PO BOX 340147
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33694-0147
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4719 BULLOCK CT
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33624-1601
Country	:	US
Telephone Number	:	813-961-0392
Fax Number	:

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

Provider Enumeration Date	:	07/29/2014
Last Update Date	:	07/29/2014

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Directions to “ LATRICIA JOHNS ” Practice Location

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