Individual
WALTER JOHNSON III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1222 S ORANGE AVE, ORLANDO, FL 32806-1215
(407) 650-1300
(407) 650-1307
Mailing address
1222 S ORANGE AVE, ORLANDO, FL 32806-1215
(407) 650-1300
(407) 650-1307
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA 9102469
FL
363AM0700X
Medical Physician Assistant
Primary
PA9102469
FL
Other
Enumeration date
10/11/2006
Last updated
07/01/2014
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