Individual
DR. DONNA CHERYLL JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8061 SPYGLASS HILL RD. SUITE 102, MELBOURNE, FL 32940
(321) 751-7041
(351) 751-7042
Mailing address
8061 SPYGLASS HILL RD. SUITE 102, MELBOURNE, FL 32940
(321) 751-7041
(351) 751-7042
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME 76813
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
259842600
—
FL
01
—
49715
BLUE CROSS BLUE SHIELD
FL
01
—
7158131
AETNA INSURANCE
FL
Enumeration date
05/23/2005
Last updated
09/02/2015
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