IndividualActive
Lyllie Johnson, MS, LAT, ATC
NPI 1437880325 · Sports Medicine (Physical Medicine & Rehabilitation) Physician · Lithia, FL
Provider details
- NPI number
- 1437880325
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Physical Medicine & Rehabilitation) PhysicianAllopathic & Osteopathic Physicians
- Credential
- MS, LAT, ATC
- Sex
- Female
- Sole proprietor
- No
- License
- 2000051414 (FL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
13837 Circa Crossing Dr
Lithia, FL 33547-4382
Phone: (203) 733-6035
Approximate (ZIP-level) locationGet directions
Mailing address
3384 Suncoast Plains Dr
Odessa, FL 33556-2935
Registry dates
- Enumerated
- 2022-06-21
- Last updated
- 2024-04-09
- Certified
- 2024-04-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.