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Individual

JENNYFER L TOMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT, PTA

Contact information

Practice address
13691 METRO PKWY 120, FORT MYERS, FL 33912-4348
(239) 768-2272
(239) 768-5549
Mailing address
13691 METRO PKWY 400, FORT MYERS, FL 33912-4349
(239) 768-2272
(239) 768-5549

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
PTA-18807
FL
225X00000X
Occupational Therapist
Primary
OT-11524
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1962545723
CIGNA
FL
01
K0865
MEDICARE GROUP
FL
Enumeration date
02/14/2007
Last updated
08/27/2015
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