Provider Demographics
NPI:1487117388
Name:JOHNER THERAPY INC
Entity type:Organization
Organization Name:JOHNER THERAPY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:FONDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-470-9399
Mailing Address - Street 1:706 SW PINE ISLAND RD UNIT 105
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-2053
Mailing Address - Country:US
Mailing Address - Phone:239-424-9904
Mailing Address - Fax:239-317-0268
Practice Address - Street 1:706 SW PINE ISLAND RD UNIT 105
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33991-2053
Practice Address - Country:US
Practice Address - Phone:239-424-9904
Practice Address - Fax:239-317-0268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-09
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT19324OtherMEDICAL LICENSE