Lavarous Antwon Johnson, PHYSICIAN ASSISTANT in Tampa, FL

Lavarous Antwon Johnson, PHYSICIAN ASSISTANT is a medicare enrolled "Physician Assistant - Medical" in Tampa, Florida. His current practice location is 401 W Kennedy Blvd, Tampa, Florida. You can reach out to his office (for appointments etc.) via phone at (757) 528-7563.

Lavarous Antwon Johnson is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1073273660.

Contact Information

	Lavarous Antwon Johnson, PHYSICIAN ASSISTANT
	401 W Kennedy Blvd, Tampa, FL 33606-1450
	(757) 528-7563
	Not Available

Map and Direction

Provider's Profile

Full Name	Lavarous Antwon Johnson
Gender	Male
Speciality	Physician Assistant - Medical
Location	401 W Kennedy Blvd, Tampa, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1073273660
Provider Enumeration Date: 12/22/2021
Last Update Date: 05/25/2023

Medicare PECOS Information:

PECOS PAC ID: 5991002024
Enrollment ID: I20220613000532

Medical Identifiers

Medical identifiers for Lavarous Antwon Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1073273660	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363AM0700X	Physician Assistant - Medical	(* (Not Available))	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lavarous Antwon Johnson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Lavarous Antwon Johnson, PHYSICIAN ASSISTANT 302 W Fletcher Ave, Tampa, FL 33612-3415 Ph: () -	Lavarous Antwon Johnson, PHYSICIAN ASSISTANT 401 W Kennedy Blvd, Tampa, FL 33606-1450 Ph: (757) 528-7563

Reviews and Comments

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Lavarous Antwon Johnson, PHYSICIAN ASSISTANT - Medicare Physician Assistant in Tampa, FL