Male or Other

Dr. Luke E. Johnsen DO

Family Medicine Physician in St Petersburg, FL(View on Map)

Full Name

Dr. Luke Elhanan Johnsen DO

NPI Number

1780781591

NPI Type

Individual Provider

Gender

Male

Enumeration Date

09/20/2006

Specialties

(Taxonomies)

Code

207Q00000X

Primary Taxonomy

Yes

Licenses

State

Florida
Maryland

License Number

OS15063
H63003

Contact
Information

Purpose

Mailing
Location

Address

3251 3RD AVE N
3251 3RD AVE N

City

St Petersburg
St Petersburg

State

FL
FL

Postal Code

33713-8506
33713

Country

US
US

Telephone Number

(727) 321-3854
(727) 321-3854

Identifiers

Identifier

6LR83A
024397500
JK078Z

Identifier State

FL
FL
FL

Identifier Issuer

BCBS
Unknown
MEDICARE

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 05/22/2019

Provider Address

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