Mrs Lisa Marie Johnson, PA | |
150 5th Ave Ste A, Indialantic, FL 32903-3154 | |
(321) 254-6803 | |
(321) 254-6819 |
Full Name | Mrs Lisa Marie Johnson |
---|---|
Gender | Female |
Speciality | Physician Assistant - Medical |
Location | 150 5th Ave Ste A, Indialantic, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1295877785 | NPI | - | NPPES |
200028010A | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363AM0700X | Physician Assistant - Medical | 1338 (Oklahoma) | Secondary |
363AM0700X | Physician Assistant - Medical | PA9108416 (Florida) | Primary |
Mailing Address | Practice Location Address |
---|---|
Mrs Lisa Marie Johnson, PA 150 5th Ave Ste A, Indialantic, FL 32903-3154 Ph: (321) 254-6803 | Mrs Lisa Marie Johnson, PA 150 5th Ave Ste A, Indialantic, FL 32903-3154 Ph: (321) 254-6803 |
Dale Phillip Greyslak, PAC Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 3491 Titanic Cir, Indialantic, FL 32903 Phone: 407-451-0192 | |
Casey Robert Runte, Physician Assistant Medicare: Medicare Enrolled Practice Location: 141 Coconut Dr, Indialantic, FL 32903 Phone: 321-610-8939 | |
Maxwell Clark Poling, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 420 5th Ave, Indialantic, FL 32903 Phone: 321-312-1352 Fax: 321-312-1513 |