Organization
FLORIDA INTERVENTIONAL PROVIDERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARRELL JOHNSON (ADMINISTRATOR)
(561) 356-6313
Entity
Organization
Contact information
Practice address
2202 SE 23RD RD, HOMESTEAD, FL 33035-1904
(201) 951-3113
(305) 675-3346
Mailing address
2202 SE 23RD RD, HOMESTEAD, FL 33035-1904
(201) 951-3113
(305) 675-3346
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Enumeration date
04/19/2021
Last updated
04/09/2026
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