Individual
CHRISTY ELLYN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
303 E PAR ST, ORLANDO, FL 32804-4003
(877) 876-3627
(321) 843-4101
Mailing address
303 E PAR ST, ORLANDO, FL 32804-4003
(877) 876-3627
(321) 843-4101
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA 9106654
FL
363AM0700X
Medical Physician Assistant
Primary
PA9106654
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100185700
—
FL
Enumeration date
08/20/2012
Last updated
04/04/2019
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