Sa-PG-Gainesville LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SNF1408096 Issued in FL

Legal business name

SA-PG-GAINESVILLE LLC

Doing business as

Palm Garden of Gainesville

Practice address

227 SW 62ND Blvd
Gainesville, FL 32607-2084

Phone

(352) 331-0601

Fax

(352) 332-9778

NPI assigned

Jun 22, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Alex Paley

Title

Coo

Phone

(914) 390-4363

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Palm Garden of Gainesville Doing business as

Tax ID family

Palm Garden of Gainesville2 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.

• Palm Garden of Gainesville LLC

  dba Palm Garden of Gainesville

  • Skilled Nursing Facility
  • Gainesville, FL
  • NPI 1093140055
  NPD tax ID

Locations

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216684800000",
    "number": "1285630582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 SW 62ND BLVD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326072084",
            "telephone_number": "352-331-0601",
            "fax_number": "352-332-9778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 SW 62ND BLVD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326072084",
            "telephone_number": "352-331-0601",
            "fax_number": "352-332-9778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SA-PG-GAINESVILLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-22",
        "last_updated": "2008-07-22",
        "status": "A",
        "authorized_official_last_name": "PALEY",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "914-390-4363",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF1408096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025726500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palm Garden of Gainesville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kyle Ryland, DO
• Carly Ryle
• Gloria Ann Ryles
• S-H Opco Gainesville, LLC (Brookdale Gainesville Southwest)
• S. Jason Pavlik (Pavlik Orthodontics)
• Shyamsunder Brindavan Sabat, M.D.
• Fred J Sabback Jr., OT
• Michelle Marie Sabino
• Alvaro Sabogal, RBT
• Robin J Sabra, PA

• Skilled Nursing Facility in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; 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.