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Individual

AMY CARTY JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 265-0301
Mailing address
PO BOX 13833, PHILADELPHIA, PA 19101-3833

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA91078326
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010033300
FL
01
PA9107326
LICENSE
FL
Enumeration date
08/30/2013
Last updated
12/23/2013
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