Provider Demographics
NPI:1336772433
Name:VAN SCHIJNDEL-BOGAARDS, JEAN (PT)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:VAN SCHIJNDEL-BOGAARDS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JEAN
Other - Middle Name:
Other - Last Name:BOGAARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:4939 PELICAN BLVD
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33914-6547
Mailing Address - Country:US
Mailing Address - Phone:239-297-4139
Mailing Address - Fax:
Practice Address - Street 1:4939 PELICAN BLVD
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33914-6547
Practice Address - Country:US
Practice Address - Phone:239-297-4139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-17
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT30088225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist