Individual
DR. MARK ANTHONY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
811 RIDGEWOOD AVENUE, VENICE, FL 34285
(941) 792-2020
Mailing address
PO BOX 162264, ALTAMONTE SPRINGS, FL 32716-2264
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME64457
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
379740600
—
FL
Enumeration date
03/07/2006
Last updated
10/04/2024
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