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Organization
SUDINE JOHNSON
Active
Organization
SUDINE JOHNSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUDINE S JOHNSON (CNA)
(321) 663-8247
Entity
Organization
Contact information
Practice address
1230 W POINTE VILLAS BLVD BLDG APT 203, WINTER GARDEN, FL 34787-6099
(321) 663-8247
Mailing address
1230 W POINTE VILLAS BLVD BLDG APT 203, WINTER GARDEN, FL 34787-6099
(321) 663-8247
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
322032
FL
Other
Enumeration date
04/27/2016
Last updated
04/27/2016
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