LIEUTENANT JOHNSON SUPERVILLE

MIRAMAR, FL
NPI1790458156
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: FL  11012823)
Enumeration Date2021-07-30
Last Update Date2021-07-30
Business Address
LIEUTENANT JOHNSON SUPERVILLE Ph.D
7928 EMBASSY BLVD
MIRAMAR, FL 33023-6412
Phone number: 954-224-4142
Mailing Address
LIEUTENANT JOHNSON SUPERVILLE Ph.D
7928 EMBASSY BLVD
MIRAMAR, FL 33023-6412
Phone number: 954-224-4142