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Individual

DR. RYAN WESLEY JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
2995 CRYSTAL BEACH RD, WINTER HAVEN, FL 33880-4914
(863) 585-4591
Mailing address
2995 CRYSTAL BEACH RD, WINTER HAVEN, FL 33880-4914
(863) 585-4591

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
DO.000283
LA
207P00000X
Emergency Medicine Physician
Primary
OS 12318
FL

Other

Enumeration date
04/10/2010
Last updated
08/19/2013
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