Organization
MARY MILLER-JOHNSON
Active
Other names
Smile With A Heart of Love
Organization subpart
No
Provider details
NPI number
Authorized official
MARY MILLER-JOHNSON (OWER/ADMINISTRATOR)
(407) 879-6062
Entity
Organization
Contact information
Practice address
5420 WOOD CROSSING ST, ORLANDO, FL 32811-7920
(407) 879-6062
Mailing address
5420 WOOD CROSSING ST, ORLANDO, FL 32811-7920
(407) 879-6062
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101952900
—
FL
Enumeration date
02/05/2022
Last updated
02/05/2022
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