Individual
MS. CHERYL L JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
943 S BENEVA RD, SUITE 306, SARASOTA, FL 34232-2476
(941) 362-8644
(941) 954-4440
Mailing address
PO BOX 863407, ORLANDO, FL 32886-3407
(941) 917-2600
(941) 917-7884
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9104060
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA9104060
PA LICENSE
FL
01
—
Y00LF
BLUE SHIELD
FL
Enumeration date
01/14/2009
Last updated
01/22/2021
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