Andrea Johnson
Individual provider Active NPI Speech-Language Pathologist · Port Saint John, FL
NPI 1710130356 · NPPES record last updated Aug 26, 2026
Key facts
- NPI
- 1710130356
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SA12868 (FL)
- Practice address
- 7185 Ann Catherine CT
Port Saint John, FL 32927-3055 - Phone
- (954) 829-2341
- NPI assigned
- Oct 28, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA12868 | FL | MD | Speech-Language Pathologist |
| SZ4669 | FL | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SZ4669 | FL | |
| Speech-Language Pathologist |
235Z00000X | SLP007386 | GA | |
| Speech-Language Pathologist | 235Z00000X | SA12868 | FL | Yes |
Addresses
Primary practice location
7185 Ann Catherine CT
Port Saint John, FL 32927-3055
Mailing address
7185 Ann Catherine CT
Port Saint John, FL 32927-3055
Phone (954) 829-2341
Other practice location 1
4310 NE 13th Ter
Oakland Park, FL 33334-4708
Phone (954) 829-2341
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000243400 | Medicaid | FL |
Other providers in Port Saint John, FL
- Haleigh Lillian Andreasen
- Susan Guattery Coleman
- Eduardo Hernandez
- Jonathan Jay Lubitz
- Dylan Patel
- Daniel Joseph Ross
- Huy Tran
- Carolyn Elizabeth Tremblay
All providers in Port Saint John, FL · Speech-Language Pathologist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 26, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.