Organization
JERRI L. JOHNSON, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY KEENEY (OFFICE MANAGER)
(407) 260-2606
Entity
Organization
Contact information
Practice address
411 MAITLAND AVE, SUITE 1001, ALTAMONTE SPRINGS, FL 32701-5448
(407) 260-2606
(407) 260-6339
Mailing address
411 MAITLAND AVE, SUITE 1001, ALTAMONTE SPRINGS, FL 32701-5448
(407) 260-2606
(407) 260-6339
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0049721
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1588648265
NPI TYPE I
FL
Enumeration date
08/16/2007
Last updated
08/16/2007
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