| Doctor Name: | LISA MONIQUE JOHNSON |
| NPI Number: | 1073763306 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | ME 101603 |
| Business Practice Address: | 555 N Byron Butler Pkwy Doctors Memorial Family Practice Perry, FL - 323472315 |
| Business Phone Number: | 8506452865 |
| Business Fax Number: | 8506452859 |
| Mailing Address: | 1115 W Call St, Fsu College Of Medicine - Room 3210-v TALLAHASSEE |
| State: | FL |
| Postal Code: | 323064300 |
| Phone Number: | 8506452865 |
| Fax Number: | 8506452859 |
| NPI Enumeration Date: | 09/23/2008 |
| NPI Last Update Date: | 04/07/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QA0000X |
| License Number: | ME 101603 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Adolescent Medicine |
| Taxonomy Definition: | A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs. |