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Organization Active NPI

Southern Winds Hospital LLC

  • Psychiatric Hospital
  • Hialeah, FL
National Provider Identifier
1285094813
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
SOUTHERN WINDS HOSPITAL LLC
Doing business as
Southern Winds
Practice address
4225 W 20TH Ave
Hialeah, FL 33012-5826
Phone
(305) 558-9700
Fax
(305) 362-5964
NPI assigned
Feb 24, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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

Authorized official

Name
Andrew Brick-Turin
Title
Cfo
Phone
(305) 558-9700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X Primary

Addresses

Primary practice location

4225 W 20TH Ave
Hialeah, FL 33012-5826

Mailing address

4225 W 20TH Ave
Hialeah, FL 33012-5826
Phone (305) 558-9700

Other identifiers 1

IdentifierTypeStateIssuer
016949600MedicaidFL

Other names 1

  • Southern Winds Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190709001752 FL Part A Provider - Hospital 2264767565 Practice locations: Hialeah, FL

Hospital certification: CCN 104049

Legal name
SOUTHERN WINDS HOSPITAL LLC
Doing business as
SOUTHERN WINDS
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Jun 29, 1989
Last certification
Mar 5, 2020
Beds
72
Ownership / control type
Private (for profit)
Most recent change of ownership
Jun 1, 2016 (1 total)
Organization structure
LLCProprietary
Incorporated
May 7, 2019 in DE
Enrollment address
4225 W 20TH Ave
Hialeah, FL 33012-5826
Other Hospital Practice Location
Hospital subgroups
Psychiatric

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Southern Winds HospitalCCN 104049 · All quality measures
Type
Psychiatric
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Southern Winds Hospital 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.

Networks

  • HealthSun Health Plans Network

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Andrew Brick-Turin Individual Corporate OfficerCfo Jun 3, 2019 100%
Ana Bovo Individual Corporate OfficerCeo Jun 3, 2019 100%
W-2 Managing EmployeeCeo Jun 3, 2019 100%
Southern Winds Hospital Holdings Organization, Miami, FL 5% Or Greater Direct Ownership Interest May 9, 2019
Abraham Shaulson Individual 5% Or Greater Indirect Ownership Interest Jun 3, 2019 100%
OtherManager Jun 3, 2019 100%

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1456272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606867200000",
    "number": "1285094813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 W 20TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330125826",
            "telephone_number": "305-558-9700",
            "fax_number": "305-362-5964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 W 20TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330125826",
            "telephone_number": "305-558-9700",
            "fax_number": "305-362-5964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN WINDS HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-24",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A",
        "authorized_official_last_name": "BRICK-TURIN",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "305-558-9700"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016949600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Winds",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southern Winds",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.