Johnson, Mitzi

Johnson, Mitzi is an individual health care provider with primary practice located at 1925 Bahia Vista St , Sarasota FL 34239-2204. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Johnson, Mitzi can be contacted via phone (941) 713-6628.

Contact Information

Primary practice address
1925 Bahia Vista St Sarasota FL 34239-2204
Phone: (941) 713-6628
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X

Profile Details

NPI number 1417942954
LBN Legal business name Johnson, Mitzi
Credentials MPH, PT
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 12th, 2005
Last updated May 7th, 2008 - about 17 years 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417942954 NPPES
Florida Other 650144307 TAX IDENTIFICATION NUMBER
Florida Other Y045V TAX IDENTIFICATION NUMBER
Florida MEDICAID 887298800 TAX IDENTIFICATION NUMBER

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