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General NPI Number Information
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NPI Number | 1215817424
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Entity Type | Individual
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Provider Name | JORDAN VAN LEUVEN
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Gender | Female
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Dates
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Enumeration Date | 09/08/2025
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 13921 SHELL POINT PLZ
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City | FORT MYERS
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State | FL
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Zip | 33908-2830
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Country | US
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Telephone | 239-441-2054
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Fax |
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Provider Business Mailing Address
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Address Line | 1133 SCHOONER PL APT A
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City | SANIBEL
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State | FL
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Zip | 33957-5006
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Country | US
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Telephone | 727-631-7223
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT21550
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License Number State | FL
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