Provider Demographics
NPI:1447427281
Name:JOHNSON, MICHAEL A (BCHIS)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:BCHIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 N ORLANDO AVE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-5574
Mailing Address - Country:US
Mailing Address - Phone:407-388-3648
Mailing Address - Fax:407-388-3650
Practice Address - Street 1:110 N ORLANDO AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-5574
Practice Address - Country:US
Practice Address - Phone:407-388-3648
Practice Address - Fax:407-388-3650
Is Sole Proprietor?:No
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS3012237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist