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1457349508
KENNETH IAN JOHNSON
PORT ST LUCIE, FL
NPI
1457349508
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: FL ME73635)
Enumeration Date
2005-10-12
Last Update Date
2018-06-28
Business Address
KENNETH IAN JOHNSON MD
1700 SE HILLMOOR DR STE 501
PORT ST LUCIE, FL 34952
Phone number: 772-212-7049
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Mailing Address
KENNETH IAN JOHNSON MD
14690 SPRING HILL DR STE 305
SPRING HILL, FL 34609-8102
Phone number: 352-277-5348
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