Southgate Medical of Florida, Inc.

Primary specialty

Parenteral & Enteral Nutrition Supplies (DME)Taxonomy code 332BP3500X

License

976 Issued in FL

Legal business name

SOUTHGATE MEDICAL OF FLORIDA, INC.

Practice address

899 NW 4TH St
Miami, FL 33128-1309

Phone

(305) 926-0960

Fax

(305) 326-1647

NPI assigned

Jan 25, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Richard Eugene Stacey Sr., LNHA

Title

Vice-President

Phone

(305) 926-0960

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154477214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "899 NW 4TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331281309",
            "telephone_number": "305-926-0960",
            "fax_number": "305-326-1647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "899 NW 4TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331281309",
            "telephone_number": "305-926-0960",
            "fax_number": "305-326-1647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHGATE MEDICAL OF FLORIDA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STACEY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "305-926-0960",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "FL",
            "license": "976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern Florida Medical Group
• Southern Flow Logistics LLC
• Southern Medical Supply USA Inc
• Southern United Management Group Inc
• Southern Wound Care LLC
• Southland Clinic
• Southside OB-GYN PLLC
• Southwest Drug'S, Inc.
• Southwest Miami Rehabilitative Center, Inc.
• Southwest Team Corp

• Parenteral & Enteral Nutrition Supplies (DME) in Miami, FL
• Providers in Miami, FL by specialty
• Parenteral & Enteral Nutrition Supplies (DME) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.