Female

Mrs. Shantana D. Johnson

Full Name

Mrs. Shantana D Johnson

NPI Number

1528734548

NPI Type

Individual Provider

Gender

Female

Enumeration Date

08/19/2021

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

Provider Address