Marco Van Den Bosch, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9108290 Issued in FL

Practice address

2780 Cleveland Ave
Suite 819
Fort Myers, FL 33901-5817

Phone

(239) 343-3800

Fax

(239) 343-3993

NPI assigned

Oct 10, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1412899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416528000000",
    "number": "1851795413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-424-1449",
            "fax_number": "239-424-1421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 CLEVELAND AVE",
            "address_2": "SUITE 819",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339015817",
            "telephone_number": "239-343-3800",
            "fax_number": "239-343-3993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DEN BOSCH",
        "first_name": "MARCO",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-10",
        "last_updated": "2014-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9108290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bert F Van Beever, MD
• Anita Van Blerk
• Krista Van Bruggen, LCSW
• Katelyn Van de Water, CAA
• Magali Van Den Bergh, M.D.
• Arie J Van Duijn, PT, EDD, OCS
• Jacqueline Van Duijn, DPT
• Ashlee Van Dusen, R.B.T.
• Katharine Van Fossen, M.D.
• Denise L Van Horn, OT

• Physician Assistant in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2014; 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.