Individual
JUDITH JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7225 N UNIVERSITY DR, STE 104, TAMARAC, FL 33321-2908
(954) 341-9771
(954) 341-9772
Mailing address
7225 N UNIVERSITY DR, SUITE 104, TAMARAC, FL 33321-2908
(954) 341-9771
(954) 341-9772
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME43407
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0072480
GHI
FL
01
—
0163191
GHI
FL
05
—
044637800
—
FL
01
—
208508
AVMED
FL
01
—
61544
BLUE CROSS BLUE SHIELD
—
Enumeration date
12/21/2005
Last updated
05/16/2008
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