Individual
MS. SANDRA Y JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1800 EDGEWOOD AVE, WEST #164, JACKSONVILLE, FL 32208-5928
(904) 318-7993
Mailing address
1800 EDGEWOOD AVE W APT 164, JACKSONVILLE, FL 32208-8004
(904) 318-7993
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
NH2114
FL
Other
Enumeration date
05/02/2007
Last updated
12/31/2012
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