Individual
KRISTOPHER JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12901 BRUCE B DOWNS BLVD, TAMPA, FL 33612-4799
(813) 974-8292
(813) 974-0483
Mailing address
12901 BRUCE B DOWNS BLVD, TAMPA, FL 33612-4742
(813) 974-8292
(813) 974-0483
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
2018086266
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
23-7313346
—
FL
Enumeration date
03/27/2019
Last updated
03/27/2019
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