DONALD E. JOHNSON, MD, PA
Ambulatory Health at 2 Ave, Miami, FL

License number
Florida ME 11465
Category
Ambulatory Health
Type
Primary Care
Owner
Name: DONALD EDWARD JOHNSON M.D.
Title: OWNER
Phone: (305) 249-9925
Address
Address
16855 NE 2Nd Ave #103, Miami, FL 33162
National Provider ID: 1205836632
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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DONALD E. JOHNSON, M.D., PA

16855 NE 2 Ave STE 103, Miami, FL 33162

Status:
Inactive
Inactive reason:
ADMIN DISSOLUTION FOR ANNUAL REPORT
Registration:
Jul 8, 1969
Inactive since:
Sep 14, 2007
State ID:
601199
Business type:
Florida Profit Corporation
Director:
Donald E Johnson Director, inactive, 16855 NE 2 Ave #103, Miami, FL 33162 (Physical)
Agent:
Donald Johnson,16855 NE 2 Ave, Miami, FL 33162 (Physical)
EIN:
59-1264362

Donald E Johnson MD PA

100 NW 170 St, Miami, FL 33169

Status:
Inactive
Industry:
Medical Doctor's Office
Medical Doctor:
C. Johnson Medical Doctor, inactive

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