Provider Demographics
NPI:1821755935
Name:JOHNSON, SYLVIA PATRICIA
Entity Type:Individual
Prefix:MS
First Name:SYLVIA
Middle Name:PATRICIA
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9900 W SAMPLE RD STE 319
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-4048
Mailing Address - Country:US
Mailing Address - Phone:954-240-8574
Mailing Address - Fax:
Practice Address - Street 1:9900 W SAMPLE RD STE 319
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4048
Practice Address - Country:US
Practice Address - Phone:954-240-8574
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-23
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program