Individual
JEAN H. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
301 NW 82ND AVE, PLANTATION, FL 33324-1811
(954) 370-1053
Mailing address
PO BOX 17347, PLANTATION, FL 33318-7347
(954) 424-7166
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME68883
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
378624200
—
FL
01
—
P00752922
MEDICARE RAILROAD
FL
Enumeration date
03/10/2006
Last updated
02/05/2010
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