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Organization

JRJ PODIATRY INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JEANETTE R JOHNSON DPM (OWNER/PRESIDENT)
(954) 731-0028
Entity
Organization

Contact information

Practice address
4000 N STATE ROAD 7, STE 412, LAUDERDALE LAKES, FL 33319-4882
(954) 731-0028
(954) 731-0288
Mailing address
4000 N STATE ROAD 7, STE 412, LAUDERDALE LAKES, FL 33319-4882
(954) 731-0028
(954) 731-0288

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO2654
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
390400801
FL
Enumeration date
06/27/2005
Last updated
12/29/2008
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