Individual
BANKOLE A. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1395 BRICKELL AVE STE 200, MIAMI, FL 33131-3312
(305) 396-6993
Mailing address
1395 BRICKELL AVE STE 200, MIAMI, FL 33131-3312
(305) 396-6993
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME117493
FL
2084P0800X
Psychiatry Physician
0101237573
VA
2084P0800X
Psychiatry Physician
ME117493
FL
208D00000X
General Practice Physician
ME117493
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010141842
—
VA
Enumeration date
02/21/2007
Last updated
03/29/2021
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