Organization
SHADETREE DERMATOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VANESSA EMILY JOHNSON MD (DERMATOLOGIST (PHYSICIAN))
(321) 200-0346
Entity
Organization
Contact information
Practice address
105 S BANANA RIVER BLVD FL 2, COCOA BEACH, FL 32931-5041
(321) 200-0346
Mailing address
105 S BANANA RIVER BLVD FL 2, COCOA BEACH, FL 32931-5041
(321) 200-0346
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
04/22/2024
Last updated
03/04/2026
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