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Individual

GABRIEL JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
1601 CLINT MOORE RD, SUITE 155, BOCA RATON, FL 33487-2768
(561) 338-0700
Mailing address
1601 CLINT MOORE RD, SUITE 155, BOCA RATON, FL 33487-2768

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9109898
FL

Other

Enumeration date
10/12/2016
Last updated
10/12/2016
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