Brandon Sports and Aquatics Center, Inc.

Primary specialty

Day Training/Habilitation SpecialistTaxonomy code 373H00000X

Legal business name

BRANDON SPORTS AND AQUATICS CENTER, INC.

Practice address

405 Beverly Blvd
Brandon, FL 33511-5507

Phone

(813) 689-0908

NPI assigned

Sep 23, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Charles W. Burgess Jr.

Title

Ceo

Phone

(813) 689-0908

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• High 5, Inc. Doing business as

Locations

Practitioners 1

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

• Joseph L Somers Jr.

  • Day Training/Habilitation Specialist
  • Brandon, FL
  • NPI 1447074224
  NPD

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

{
    "created_epoch": "1727049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736208000000",
    "number": "1114744067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 BEVERLY BLVD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115507",
            "telephone_number": "813-689-0908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 BEVERLY BLVD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115507",
            "telephone_number": "813-689-0908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANDON SPORTS AND AQUATICS CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-23",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A",
        "authorized_official_last_name": "BURGESS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "813-689-0908",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "373H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Day Training/Habilitation Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120040300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "High 5, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brandon Regional Hospital
• Brandon SLC Opco, LLC
• Brandon Smiles
• Brandon Smiles LLC
• Brandon Smiles,LLC
• Brandon Stem Cell Clinic LLC
• Brandon TMS & Psychiatry
• Brandon Wellness Center LLC
• Brandon-Riverview Medical Associates PA
• Ashley Quonsha Shavar Brandon, APRN

• Day Training/Habilitation Specialist in Brandon, FL
• Providers in Brandon, FL by specialty
• Day Training/Habilitation Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; 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.