Individual
MS. KIMENITA ROSUNDA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
INDIVIDUAL PROVIDER
Contact information
Practice address
14961 TYLER ST, MIAMI, FL 33176-7640
(786) 486-6855
(305) 688-1415
Mailing address
14961 TYLER ST, MIAMI, FL 33176-7640
(786) 486-6855
(305) 688-1415
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
230621
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
230621
HOMEMAKER &COMPANION SERVICES
FL
Enumeration date
06/18/2008
Last updated
06/18/2008
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