Most Relevant Information
Provider Data
| NPI Number: | 1003223298 |
| Provider Name: | KENNETH JOHNSON LAT, ATC |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: | AL 3447 |
Most Important Dates
| Enumeration Date: | 07/19/2014 |
| Last Updated: | 07/19/2014 |
Provider Practice Location
6201 SAN AMARO DR
CORAL GABLES
FL
331462407
Practice Location Phone/Fax
| Phone: | 3052845286 |
| Fax: |
Provider Mailing Location
6201 SAN AMARO DR
CORAL GABLES
FL
331462407
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |