Provider Demographics
NPI:1487620993
Name:JOHNSON, CHRISTOPHER JAMES (DO)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JAMES
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:10000 W COLONIAL DR
Mailing Address - Street 2:SUITE 288
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-3498
Mailing Address - Country:US
Mailing Address - Phone:407-521-3600
Mailing Address - Fax:407-521-3603
Practice Address - Street 1:1804 OAKLEY SEAVER BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-1925
Practice Address - Country:US
Practice Address - Phone:352-243-2622
Practice Address - Fax:352-243-6277
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS8746208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL265513600Medicaid
FL18001OtherBCBS NUMBER
FL18001XMedicare ID - Type UnspecifiedORANGE COUNTY MEDICARE
FL18001YMedicare ID - Type UnspecifiedLAKE COUNTY MEDICARE
FL265513600Medicaid