Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Miss. Jaquitsha La'Kwonshay Tyson-Johnson

Individual provider Prosthetic/Orthotic Supplier · NPI 1063239572

Miss. Jaquitsha La'Kwonshay Tyson-Johnson is a Prosthetic/Orthotic Supplier in Palm City, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2024

Practice location Address checks out

2047 SW Danforth Cir
Palm City, FL 34990-7704
Phone: (772) 485-2242
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Prosthetic/Orthotic Supplier (primary) Taxonomy 335E00000X (FL)

Record details

NPI number1063239572
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedSeptember 25, 2024
Last updated in NPPESNovember 9, 2024
Certification dateNovember 9, 2024

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