Individual
MAKALA QUINN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
22 W UNDERWOOD ST, ORLANDO, FL 32806-1110
(321) 841-5111
Mailing address
22 UNDERWOOD ST, ORLANDO, FL 32806-1110
(407) 648-3800
(407) 872-7754
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
9116392
FL
363AM0700X
Medical Physician Assistant
PA9116392
FL
363AS0400X
Surgical Physician Assistant
Primary
PA9116392
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116504700
—
FL
Enumeration date
10/04/2022
Last updated
03/02/2026
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