Individual
RYAN MAURICE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 36TH ST, VERO BEACH, FL 32960-4862
(772) 567-4311
Mailing address
3055 BERKLEY SQUARE WAY, VERO BEACH, FL 32966-1400
(732) 865-1441
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME0158878
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
FL
Other
Enumeration date
04/08/2020
Last updated
10/15/2023
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