Individual
HEATHER A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
3100 E FLETCHER AVE, TAMPA, FL 33613-4613
(813) 971-6000
(813) 615-7590
Mailing address
12479 TELECOM DR, TAMPA, FL 33637-0913
(813) 972-4199
(813) 972-5753
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00003023
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E1613X
BCBS OF FLORIDA
FL
Enumeration date
05/24/2006
Last updated
03/16/2015
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