Mrs. Shantana D. Johnson
Full Name
Mrs. Shantana D Johnson
NPI Number
1528734548
NPI Type
Individual Provider
Gender
Female
Enumeration Date
08/19/2021
Specialties
(Taxonomies)Name
Code
385HR2060X
385HR2055X
385HR2065X
253J00000X
376J00000X
253Z00000X
320600000X
385H00000X
385HR2050X
Primary Taxonomy
No
No
No
No
No
No
No
No
No
Contact
Information
Purpose
Mailing
Location
Address
1190 BLARNEY ST
1920 VERANO DR STE 105
City
Minneola
Haines City
State
FL
FL
Postal Code
34715-7634
33844-8585
Country
US
US
Telephone Number
(321) 217-2409
(321) 217-2409
Identifiers
Identifier
022449300
108545900
Identifier State
FL
FL
Identifier Issuer
Unknown
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 06/26/2024