Provider Demographics
NPI:1811930761
Name:SIEGEL, JANET MARIE (PT)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:MARIE
Last Name:SIEGEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:MARIE
Other - Last Name:COLLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:700 EL DORADO PKWY W
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33914-7232
Mailing Address - Country:US
Mailing Address - Phone:239-573-4438
Mailing Address - Fax:239-945-5441
Practice Address - Street 1:700 EL DORADO PKWY W
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33914-7232
Practice Address - Country:US
Practice Address - Phone:239-573-4438
Practice Address - Fax:239-945-5441
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 5688225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU4332AMedicare ID - Type UnspecifiedPT IN PRIVATE PRACTICE