Willie Johnson, GM
Willie Johnson, GM is a Parenteral & Enteral Nutrition Supplies (DME) in Auburndale, Florida. Practices as a sole proprietor. Licensed in Florida.
- Licensed in
- FL
- In the registry since
- 2022
- Specialties on file
- 2
Practice location Address checks out
108 Julie LnAuburndale, FL 33823-2335
Phone: (863) 269-8897
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Customized Equipment (DME) (primary) | Taxonomy 332BC3200X · Licence 207683 (FL) |
|---|---|
| Parenteral & Enteral Nutrition Supplies (DME) | Taxonomy 332BP3500X · Licence 207693 (FL) |
Record details
| NPI number | 1801517651 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | GM |
| Sole proprietor | Yes |
| NPI enumerated | September 9, 2022 |
| Last updated in NPPES | September 9, 2022 |
| Certification date | September 9, 2022 |
| Mailing address | 23781 Hwy 27 # 226, Lake Wales, FL 33859-7802 |