Individual provider · Type 1 NPI
Willie Johnson, GM
Customized Equipment (DME) · Auburndale, FL
NPI number
1801517651
Active
Practice location
108 Julie Ln
Auburndale, FL 33823-2335
Mailing address
23781 Hwy 27 # 226
Lake Wales, FL 33859-7802
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Parenteral & Enteral Nutrition Supplies (DME) | 332BP3500X | 207693 (FL) |
| Customized Equipment (DME) Primary | 332BC3200X | 207683 (FL) |
Customized Equipment (DME): Definition to come...
About NPI 1801517651
Willie Johnson, GM's National Provider Identifier is 1801517651, issued on Sep 9, 2022. The primary taxonomy on file is Customized Equipment (DME) (332BC3200X), and the practice location is in Auburndale, FL. The record was last updated on Sep 9, 2022.