Provider Demographics
NPI:1609312610
Name:DR ERIKA LEIGH JOHNSON MD
Entity Type:Organization
Organization Name:DR ERIKA LEIGH JOHNSON MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-595-9939
Mailing Address - Street 1:12250 TAMIAMI TRL E
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34113-8108
Mailing Address - Country:US
Mailing Address - Phone:239-595-9939
Mailing Address - Fax:888-711-3539
Practice Address - Street 1:12250 TAMIAMI TRL E
Practice Address - Street 2:SUITE 201
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34113-8108
Practice Address - Country:US
Practice Address - Phone:239-595-9939
Practice Address - Fax:888-711-3539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-13
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME124467261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIH732ZMedicare PIN