Individual
MATTHEW KALEB JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
52 W UNDERWOOD ST, ORLANDO, FL 32806-1110
(321) 841-5111
Mailing address
1031 GAGE AVE, DELTONA, FL 32738-7128
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
5271264
ID
Other
Enumeration date
03/02/2023
Last updated
07/15/2025
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