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Individual

ELIZABETH RENEE JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
11760 SW 40TH ST STE 352, MIAMI, FL 33175-3595
(786) 428-1059
(786) 428-1062
Mailing address
11760 SW 40TH ST STE 352, MIAMI, FL 33175-3595
(786) 428-1059
(786) 428-1062

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MT205068
PA
2086S0129X
Vascular Surgery Physician
Primary
ME142033
FL

Other

Enumeration date
07/24/2013
Last updated
12/06/2021
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