LAVAROUS ANTWON JOHNSON PHYSICIAN ASSISTANT NPI 1073273660

NPI Information

  • NPI: 1073273660
  • Provider Name: LAVAROUS ANTWON JOHNSON, PHYSICIAN ASSISTANT
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 401 W KENNEDY BLVD
    TAMPA, FL
    ZIP 33606
  • Phone: (757) 528-7563

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NPI Details

Lavarous Antwon Johnson, PHYSICIAN ASSISTANT is a medical physician assistant in Tampa, FL with 5 years of experience. Lavarous Antwon Johnson, PHYSICIAN ASSISTANT NPI is 1073273660. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

401 W KENNEDY BLVD
TAMPA, FL
ZIP 33606-450
Phone: (757) 528-7563

The NPI 1073273660 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/22/2021 and was last updated on 5/25/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AM0700XPhysician AssistantMedicalYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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