Banyan Gulf Breeze LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

BANYAN GULF BREEZE LLC

Practice address

4400 Hickory Shores Blvd
Gulf Breeze, FL 32563-9111

Phone

(954) 533-7705

Fax

(754) 206-8522

NPI assigned

Jul 21, 2023

Organization subpart

No

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

Authorized official

Name

John Sory

Title

Ceo

Phone

(954) 533-7705

Specialties & licenses 2

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Banyan Gulf Breeze LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Banyan Gulf Breeze LLC

  • Substance Abuse Rehabilitation Facility
  • Gulf Breeze, FL
  • NPI 1386321180
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eric E Goldberg, DO

  • Psychiatry Physician
  • Destin, FL
  • NPI 1679524946
  NPD (past)

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

{
    "created_epoch": "1689897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747094400000",
    "number": "1033899372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 N FEDERAL HWY",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330624319",
            "fax_number": "954-781-7173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 HICKORY SHORES BLVD",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325639111",
            "telephone_number": "954-533-7705",
            "fax_number": "754-206-8522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANYAN GULF BREEZE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-21",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A",
        "authorized_official_last_name": "SORY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "954-533-7705"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122548100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elaine M Bailey, PHD
• Randall Scott Bailey Sr., D.M.D.
• Lola Baker, LMT
• Balance Behavioral Health, LLC
• Randy Gene Banks, PA-C
• Banyan Gulf Breeze LLC
• Baptist Health Care, Inc
• Baptist Health Care, Inc.
• Baptist Hospital, Inc.
• Baptist Medical Group LLC

• Substance Abuse Rehabilitation Facility in Gulf Breeze, FL
• Providers in Gulf Breeze, FL by specialty
• Substance Abuse Rehabilitation Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.