Organization
DRAGONFLY SUPPORT COORDINATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERRY JOHNSON (WAIVER SUPPORT COORDINATOR)
(386) 965-5418
Entity
Organization
Contact information
Practice address
3216 NW 47TH PL, GAINESVILLE, FL 32605-1100
(352) 262-7672
Mailing address
3216 NW 47TH PL, GAINESVILLE, FL 32605-1100
(352) 262-7672
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110051800
—
FL
Enumeration date
02/03/2022
Last updated
02/03/2022
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