Individual
DR. DALE S JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
983 W STATE ROAD 434, LONGWOOD, FL 32750-5103
(407) 261-0505
(407) 831-4936
Mailing address
983 W STATE ROAD 434, LONGWOOD, FL 32750-5103
(407) 261-0505
(407) 831-4936
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC 2675
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
621271900
—
FL
01
—
65054
PREMIER EYECARE
FL
Enumeration date
07/22/2008
Last updated
05/20/2013
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