Johnson Internal Medicine Inc | |
1601 Clint Moore Rd #155 Boca Raton FL 33487-2768 | |
(561) 338-0700 | |
(561) 362-9960 |
Full Name | Johnson Internal Medicine Inc |
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Speciality | Internal Medicine |
Location | 1601 Clint Moore Rd, Boca Raton, Florida |
Authorized Official Name and Position | C Robert Johnson (PRESIDENT) |
Authorized Official Contact | 5613380700 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Johnson Internal Medicine Inc 1601 Clint Moore Rd 155 Boca Raton FL 33487-2768 Ph: (561) 338-0700 | Johnson Internal Medicine Inc 1601 Clint Moore Rd #155 Boca Raton FL 33487-2768 Ph: (561) 338-0700 |
NPI Number | 1285663096 |
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Provider Enumeration Date | 07/02/2006 |
Last Update Date | 05/26/2011 |
Medicare PECOS PAC ID | 8921194820 |
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Medicare Enrollment ID | O20071023000253 |
Identifier | Type | State | Issuer |
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1285663096 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | OS0004672 (Florida) | Primary |
Provider Name | Charles R Johnson |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1992999122 PECOS PAC ID: 4284728882 Enrollment ID: I20070913000162 |
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