Southern Therapies of North Florida Inc

Primary specialty

Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X

Legal business name

SOUTHERN THERAPIES OF NORTH FLORIDA INC

Doing business as

Southern Therapy and Wellness Center

Practice address

6050 Saint Johns Ave
Suite 1
Palatka, FL 32177-3895

Phone

(386) 312-0022

Fax

(386) 312-0535

NPI assigned

Sep 8, 2005

Organization subpart

No

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

Authorized official

Name

Amanda Bennett

Title

Billing Agent

Phone

(386) 312-0022

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Southern Therapy and Wellness Center Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Southern Therapies of North Florida

  • Occupational Therapist
  • Palatka, FL
  • NPI 1871514752

  O20100903000984

  Same enrollment

Tax ID family

Southern Therapies of North Florida2 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.

• Southern Therapies of North Florida

  • Occupational Therapist
  • Palatka, FL
  • NPI 1871514752
  NPD tax ID

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281571200000",
    "number": "1053305748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6050 SAINT JOHNS AVE",
            "address_2": "SUITE 1",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321773895",
            "telephone_number": "386-312-0022",
            "fax_number": "386-312-0535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6050 SAINT JOHNS AVE",
            "address_2": "SUITE 1",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321773895",
            "telephone_number": "386-312-0022",
            "fax_number": "386-312-0535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN THERAPIES OF NORTH FLORIDA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-08",
        "last_updated": "2010-08-12",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "BILLING AGENT",
        "authorized_official_telephone_number": "386-312-0022"
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6762204-00",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "884914500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Therapy and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Juliana Sobczyk, MD
• Solaris Healthcare Palatka LLC
• Somnia Sleep Solutions LLC
• Sodang Daniel Sou, PHARMACIST
• Southern Therapies of North Florida
• Brian J Sprenger, ARNP
• St Augustine Physicians Associates, Inc.
• St Johns Eye Care P a
• St. Augustine Physician Associates, Inc
• St. Johns River Dental

• Comprehensive Outpatient Rehabilitation Facility (CORF) in Palatka, FL
• Providers in Palatka, FL by specialty
• Comprehensive Outpatient Rehabilitation Facility (CORF) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.