Individual
EARNEST JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11925 BRIGHTON KNOLL LOOP, RIVERVIEW, FL 33579-2201
(813) 668-4420
Mailing address
11925 BRIGHTON KNOLL LOOP, RIVERVIEW, FL 33579-2201
(813) 668-4420
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9406449
FL
172A00000X
Driver
Primary
J525218734150
FL
172A00000X
Driver
J525553845310
FL
Other
Enumeration date
09/18/2023
Last updated
09/18/2023
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