# MARK JOHNSON MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730152752
- **Authorized official:** MRS. KAREN LEIGH JOHNSON (SECRETARY TREASURER PRACTICE MANAGE)
- **Authorized official phone:** (941) 918-9522

## Contact information

- **Practice address:** 811 RIDGEWOOD AVE, VENICE, FL 34285
- **Practice address phone:** (941) 480-0600
- **Practice address fax:** (941) 485-8090
- **Mailing address:** 1824 ISLAND WAY, OSPREY, FL 34229
- **Mailing address phone:** (941) 918-9522
- **Mailing address fax:** (941) 918-1482

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | ME64457 | FL | Yes |

## Other

- **Enumeration date:** 02/09/2006
- **Last updated:** 08/22/2020