Individual
ELBA MARINA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
31 BARKLEY CIR, FORT MYERS, FL 33907-7628
(239) 600-7165
Mailing address
13231 SEASIDE HARBOUR DR, N FT MYERS, FL 33903-7118
(239) 565-0004
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5248559
FL
Other
Enumeration date
07/17/2023
Last updated
07/17/2023
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