Southern Gardens, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

8937 Issued in FL

Legal business name

SOUTHERN GARDENS, LLC

Practice address

255 E Main St
Lake Alfred, FL 33850-2133

Phone

(863) 956-0411

Fax

(863) 956-0164

NPI assigned

Mar 23, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Debra J Earp

Title

Controller

Phone

(863) 293-0072

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285751370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 E MAIN ST",
            "city": "LAKE ALFRED",
            "state": "FL",
            "postal_code": "338502133",
            "telephone_number": "863-956-0411",
            "fax_number": "863-956-0164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 E MAIN ST",
            "city": "LAKE ALFRED",
            "state": "FL",
            "postal_code": "338502133",
            "telephone_number": "863-956-0411",
            "fax_number": "863-956-0164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN GARDENS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EARP",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "863-293-0072",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "8937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Don Rexroad, PTA
• Tatianna Rivera Pagan
• Zeena Satar, MSN, FNP-C
• Regina Solomon
• Southern Gardens FL Al Management LLC (The Gardens of Lake Alfred)
• Wong Family Dental Center, PA
• Anthony Ignatius Wong, DDS
• Carol Wong, DDS
• Tara Woodward, PTA
• Breanna Wortelman

• Assisted Living Facility in Lake Alfred, FL
• Providers in Lake Alfred, FL by specialty
• Assisted Living Facility 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.