Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225400000X | Rehabilitation Practitioner | OT9490 | FL |
N | 225CA2400X | Assistive Technology Practitioner | OT9490 | FL |
N | 225CA2500X | Assistive Technology Supplier | OT9490 | FL |
Y | 225X00000X | Occupational Therapist | OT9490 | FL |
N | 225XE0001X | Environmental Modification | OT9490 | FL |
N | 225XG0600X | Occupational Therapist - Gerontology | OT9490 | FL |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT9490 | FL |
NPI | 1861792749 |
---|---|
Provider Name | Mr. James E. Johnson |
First Address | Gainesville, FL 32653-2040 |
Second Address | Gainesville, FL 32653-2040 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2010 |
Last Update Date | 26/10/2010 |