Individual
LATASHA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
205 SW 75TH ST APT 2H, GAINESVILLE, FL 32607-1721
(352) 301-2435
Mailing address
205 SW 75TH ST APT 2H, GAINESVILLE, FL 32607-1721
(352) 301-2435
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
J525536755287
FL
Other
Enumeration date
11/30/2015
Last updated
11/30/2015
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