| De'la Johnson, NURSE PRACTITIONER | |
|
Po Box 1268, New Smyrna Beach, FL 32170-1268 | |
| (386) 259-8803 | |
| (386) 213-9981 |
| Full Name | De'la Johnson |
|---|---|
| Gender | Female |
| Speciality | Pain Medicine - Pain Medicine |
| Location | Po Box 1268, New Smyrna Beach, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356122634 | NPI | - | NPPES |
| APRN1029119 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208VP0000X | Pain Medicine - Pain Medicine | APRN11029119 (Florida) | Primary |
| 207Q00000X | Family Medicine | APRN11029119 (Florida) | Secondary |
| Entity Name | D.h. Medical, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477855815 PECOS PAC ID: 6103014618 Enrollment ID: O20101228000869 |
| Mailing Address | Practice Location Address |
|---|---|
| De'la Johnson, NURSE PRACTITIONER Po Box 1268, New Smyrna Beach, FL 32170-1268 Ph: (386) 259-8803 | De'la Johnson, NURSE PRACTITIONER Po Box 1268, New Smyrna Beach, FL 32170-1268 Ph: (386) 259-8803 |
Mr. Muhammad Emdadul Haque, MD Pain Medicine Medicare: Accepting Medicare Assignments Practice Location: 412 Palmetto Street, New Smyrna Beach, FL 32168 Phone: 386-427-4752 Fax: 386-426-8855 | |
Ilze Hicks, M.D. Pain Medicine Medicare: Medicare Enrolled Practice Location: Po Box 1268, New Smyrna Beach, FL 32170 Phone: 386-259-8803 Fax: 386-213-9981 |