Organization Active NPI

Mjboman, LLC

Doing business as The Bridge Physical Therapy

  • Physical Medicine & Rehabilitation Physician
  • Cape Coral, FL
National Provider Identifier
1851073449
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
MJBOMAN, LLC
Doing business as
The Bridge Physical Therapy
Practice address
1807 SE 8TH Ave
Cape Coral, FL 33990-2399
Phone
(727) 954-0125
NPI assigned
Aug 2, 2023
Last updated
May 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Authorized official

Name
Michael Boman, PT, DPTNPI 1336514009
Title
Owner/Member
Phone
(727) 954-0125

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

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

Mailing address

1807 SE 8TH Ave
Cape Coral, FL 33990-2399
Phone (727) 954-0125

Other names 1

  • The Bridge Physical Therapy Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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"
        }
    ]
}

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 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.