Individual
CRYSTAL JOHNSON-MANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-0109
(352) 265-0761
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101261806
VA
208600000X
Surgery Physician
LL34777
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100283200
—
FL
Enumeration date
06/06/2012
Last updated
01/03/2019
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