Provider Demographics
NPI:1235543604
Name:JOHNSON, FRANK JR
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:
Last Name:JOHNSON
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:561 CALIBRE CREST PKWY APT 201
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-3608
Mailing Address - Country:US
Mailing Address - Phone:407-421-5089
Mailing Address - Fax:
Practice Address - Street 1:561 CALIBRE CREST PKWY APT 201
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-3608
Practice Address - Country:US
Practice Address - Phone:407-421-5089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-13
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator