Provider Demographics
NPI:1992096788
Name:JM2GO, LLC.
Entity type:Organization
Organization Name:JM2GO, LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SANTO
Authorized Official - Middle Name:IGNACIO
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:239-565-8300
Mailing Address - Street 1:PO BOX 61105
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33906-1105
Mailing Address - Country:US
Mailing Address - Phone:239-565-8300
Mailing Address - Fax:239-829-4709
Practice Address - Street 1:9400 GLADIOLUS DR
Practice Address - Street 2:SUITE #60
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-6699
Practice Address - Country:US
Practice Address - Phone:239-565-8300
Practice Address - Fax:239-565-8300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-27
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT11998225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty