Mjboman, LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

MJBOMAN, LLC

Practice address

1807 SE 8TH Ave
Cape Coral, FL 33990-2399

Phone

(727) 954-0125

NPI assigned

Aug 2, 2023

Organization subpart

No

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

Authorized official

Name

Michael Boman, PT, DPT

Title

Owner/Member

Phone

(727) 954-0125

Specialties & licenses 1

Addresses

Other names 1

• The Bridge Physical Therapy Doing business as

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

{
    "created_epoch": "1690934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715126400000",
    "number": "1851073449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1807 SE 8TH AVE",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339902399",
            "telephone_number": "727-954-0125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1807 SE 8TH AVE",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339902399",
            "telephone_number": "727-954-0125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MJBOMAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-02",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A",
        "authorized_official_last_name": "BOMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "727-954-0125",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Bridge Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Candice Mitchell, LMHC
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• Thomas Raymond Mitchell, MD
• Anusha Mittapalli, MD
• MLC Behavior Care LLC
• Mobile Diagnostic Services, LLC
• Mobility Therapy Providers Inc
• Modern Dental Cape Coral PLLC
• Dieulene Moise, FNP-C

• Physical Medicine & Rehabilitation Physician in Cape Coral, FL
• Providers in Cape Coral, FL by specialty
• Physical Medicine & Rehabilitation Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; 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.