Johnson, Shantana D

Johnson, Shantana D is an sole proprietor health care provider with primary practice located at 1920 Verano Dr Ste 105 , Haines City FL 33844-8585. She recently has 10 registered licenses in different health care specialties including Agencies / Foster Care Agency, Agencies / In Home Supportive Care, Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, Respite Care Facility / Respite Care, Mental Illness, Child, Nursing Service Related Providers / Homemaker, Respite Care Facility / Respite Care, Respite Care Facility / Respite Care Camp, Respite Care Facility / Respite Care, Mental Retardation and/or Developmental Disabilities, Respite Care Facility / Respite Care, Physical Disabilities, Child, Agencies / Home Health. Agencies / Home Health is her primary health care specialty. Johnson, Shantana D can be contacted via phone (321) 217-2409.

Contact Information

Primary practice address
1920 Verano Dr Ste 105 Haines City FL 33844-8585
Fax: (855) 257-1340
Website:

Profile Details

NPI number 1528734548
LBN Legal business name Johnson, Shantana D
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 19th, 2021
Last updated Jun 26th, 2024 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528734548 NPPES
Florida MEDICAID 022449300
Florida MEDICAID 108545900

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