Shantae Renee Johnson

NPI #1497304646 in Poinciana, Florida

Provider Information

NPI Number: 1497304646
Entity Type: Individual
Name: Shantae Renee Johnson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Driver
Enumeration Date: Sep 10, 2019
Last Updated: Sep 10, 2019

Practice Location

Address: 560 BIG SIOUX CT
City: Poinciana
State: Florida
ZIP Code: 34759-5927
Phone: (863) 205-7815

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Driver	172A00000X	Primary

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