Kenneth Ian Johnson, MD | |
1700 Se Hillmoor Dr Ste 501, Port St Lucie, FL 34952 | |
(772) 212-7049 | |
(772) 212-7059 |
Full Name | Kenneth Ian Johnson |
---|---|
Gender | Male |
Speciality | Family Medicine |
Location | 1700 Se Hillmoor Dr Ste 501, Port St Lucie, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1457349508 | NPI | - | NPPES |
80193338 | Other | FL | RAILROAD |
ME73635 | Other | FL | VHN |
578869751 | Other | FL | TRICARE |
BCBS | Other | FL | 35407 |
ME73635 | Other | FL | DCWO |
ME73635 | Other | FL | UNITED BENEFITS |
258874900 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | ME73635 (Florida) | Primary |
Entity Name | Treasure Coast Community Health Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1891740916 PECOS PAC ID: 4082625827 Enrollment ID: O20130401000508 |
Mailing Address | Practice Location Address |
---|---|
Kenneth Ian Johnson, MD 14690 Spring Hill Dr Ste 305, Spring Hill, FL 34609-8102 Ph: (352) 277-5348 | Kenneth Ian Johnson, MD 1700 Se Hillmoor Dr Ste 501, Port St Lucie, FL 34952 Ph: (772) 212-7049 |
Dr. Adan Fernando Hernandez, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1800 Se Tiffany Ave, Port St Lucie, FL 34952 Phone: 772-237-0813 Fax: 772-238-2004 | |
Isabel Teresa Casariego Cruz, M.D Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1651 Se Tiffany Ave, Port St Lucie, FL 34952 Phone: 772-398-1800 Fax: 772-398-1828 | |
Dr. David A. Hurst, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 537 Nw Lake Whitney Pl, Port St Lucie, FL 34986 Phone: 772-335-9600 | |
Dr. Pablo H Tirado, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1700 Se Hillmoor Dr, Suite 200, Port St Lucie, FL 34952 Phone: 772-335-9600 Fax: 772-398-7951 | |
Dr. Lisa Akiye Yamamoto, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1651 Se Tiffany Ave, Port St Lucie, FL 34952 Phone: 772-398-1800 Fax: 772-398-1825 | |
Dr. Konstantin Alekseyenko, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 10080 Sw Innovation Way Ste 201, Port St Lucie, FL 34987 Phone: 772-344-3811 Fax: 772-344-3890 | |
Wojciech Marek Roczniak, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1651 Se Tiffany Ave, Port St Lucie, FL 34952 Phone: 772-398-1800 |