Organization
GENNETT JOHNSON, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GENNETT JOHNSON MD (PHYSICIAN)
(407) 616-0239
Entity
Organization
Contact information
Practice address
9068 GREAT HERON CIR, ORLANDO, FL 32836-5483
(407) 616-0239
(407) 876-2869
Mailing address
PO BOX 22948, ORLANDO, FL 32830-2948
(407) 616-0239
(407) 876-2869
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME 47316
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
061741500
—
FL
01
—
14151
BCBS
FL
Enumeration date
01/25/2007
Last updated
10/21/2016
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