Individual
LUIS ANDRES JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
7950 LAKE UNDERHILL RD, ORLANDO, FL 32822-8229
(407) 658-2046
Mailing address
2740 PALM ISLE WAY, ORLANDO, FL 32829-8578
(407) 456-2315
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
15744
FL
Other
Enumeration date
06/05/2017
Last updated
06/05/2017
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