Individual
DR. DEATRA L JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
6005 SAINT AUGUSTINE RD, JACKSONVILLE, FL 32217-2139
(904) 733-7600
Mailing address
11502 TORI LN, JACKSONVILLE, FL 32218-8833
(904) 502-2851
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS52182
FL
Other
Enumeration date
12/12/2020
Last updated
12/12/2020
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