MATTHEW SHANNON JOHNSON

PORT CHARLOTTE, FL
NPI1659711455
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: FL  OS15650)
Additional Taxonomies207P00000X Emergency Medicine
(Licence: WV  3011)
207Q00000X Family Medicine
(Licence: VA  0116026356)
Enumeration Date2013-06-26
Last Update Date2023-12-28
Business Address
MATTHEW SHANNON JOHNSON D.O.
2450 TAMIAMI TRL STE A
PORT CHARLOTTE, FL 33952-3922
Phone number: 941-624-2704
Mailing Address
MATTHEW SHANNON JOHNSON D.O.
2675 WINKLER AVE FL 2
FORT MYERS, FL 33901-9342
Phone number: 877-856-3774