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1760595961
EDWARD ALAN JOHNSON
ST AUGUSTINE, FL
NPI
1760595961
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: FL PA3355)
Enumeration Date
2006-08-15
Last Update Date
2007-07-08
Business Address
Mr. EDWARD ALAN JOHNSON PAC
1099 A1A BEACH BLVD
ST AUGUSTINE, FL 32080
Phone number: 904-471-9104
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Mailing Address
Mr. EDWARD ALAN JOHNSON PAC
10 13TH STREET
ST AUGUSTINE, FL 32080
Phone number: 904-540-7740
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