Organization
TIDEWATER FOOT & ANKLE ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MEGAN JOHNSON DPM (OWNER/ PHYSICIAN)
(813) 925-9431
Entity
Organization
Contact information
Practice address
4168 WOODLANDS PKWY STE B, PALM HARBOR, FL 34685-3496
(813) 925-9431
Mailing address
4168 WOODLANDS PKWY STE B, PALM HARBOR, FL 34685-3496
(813) 925-9431
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO3663
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7720870001
DMERC
FL
Enumeration date
03/27/2018
Last updated
06/10/2024
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