Johnson, Keith B
Johnson, Keith B is an sole proprietor health care provider with primary practice located at 1370 E Venice Ave Suite 202, Venice FL 34285-9082. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Johnson, Keith B can be contacted via phone (941) 480-0500.Contact Information
Primary practice address
1370 E Venice Ave Suite 202
Venice FL 34285-9082
Phone: (941) 480-0500
Fax: (941) 480-9322
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | ME58404 | Florida |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ME58404 | Florida |
Profile Details
| NPI number | 1184695710 |
|---|---|
| LBN Legal business name | Johnson, Keith B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 31st, 2006 |
| Last updated | Feb 6th, 2024 - about 9 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184695710 | NPPES |
| Florida | MEDICAID | 372134500 | |
| Florida | Other | 203445431 |
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