Individual
DR. JEFFERY ALAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
92 W MILLER ST, 8TH FLOOR, ORLANDO, FL 32806-2032
(321) 841-7970
(321) 841-7978
Mailing address
92 W MILLER ST, 8TH FLOOR, ORLANDO, FL 32806-2032
(321) 841-7970
(321) 841-7978
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A81750
CA
2080P0210X
Pediatric Nephrology Physician
Primary
ME119884
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A81750
BLUE SHIELD
—
05
—
011160500
—
FL
01
—
ME119884
MEDICAL LICENSE
FL
Enumeration date
04/03/2006
Last updated
11/15/2016
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