Individual
MR. ANDRE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1368 S WASHINGTON AVE, CLEARWATER, FL 33756-6503
(813) 455-7609
Mailing address
PO BOX 4953, CLEARWATER, FL 33758-4953
(813) 455-7609
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
04/26/2019
Last updated
04/26/2019
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