Individual provider Active NPI

Kenna Josephine Valdovinos, DPT

  • Physical Therapist
  • Cape Coral, FL
National Provider Identifier
1578110763
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
34871 Issued in FL
Practice address
1402 SE 16TH PL
Cape Coral, FL 33990-3819
Phone
(239) 772-2363
NPI assigned
Aug 22, 2019
Last updated
Aug 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 34871 FL Primary

Addresses

Primary practice location

1402 SE 16TH PL
Cape Coral, FL 33990-3819

Mailing address

1779 Red Cedar Dr Apt 17
Fort Myers, FL 33907-7632
Phone (046) 106-2589

Other practice location 1

6314 Whiskey Creek Dr
Fort Myers, FL 33919-8762
Phone (239) 432-0556

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34871FLMDPhysical Therapist

Networks

  • Freedom Health HMO Network

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1578110763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1779 RED CEDAR DR APT 17",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339077632",
            "telephone_number": "046-106-2589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 SE 16TH PL",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339903819",
            "telephone_number": "239-772-2363"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6314 Whiskey Creek Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339198762",
            "country_code": "US",
            "telephone_number": "239-432-0556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALDOVINOS",
        "first_name": "KENNA",
        "middle_name": "JOSEPHINE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-22",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "34871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.