Southern Oaks Facility Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SNF1556096 Issued in FL

Legal business name

SOUTHERN OAKS FACILITY INC

Practice address

600 W Gregory St
Pensacola, FL 32502-4744

Phone

(850) 437-3131

NPI assigned

Apr 29, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Michael Bleich

Title

Authorized Representative

Phone

(845) 641-8314

Specialties & licenses 1

Addresses

Other names 1

• Southern Oaks Care Center Doing business as

Locations

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430265600000",
    "number": "1295112258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4302 HOLLYWOOD BLVD",
            "address_2": "#369",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W GREGORY ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325024744",
            "telephone_number": "850-437-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN OAKS FACILITY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-29",
        "last_updated": "2015-04-29",
        "status": "A",
        "authorized_official_last_name": "BLEICH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "845-641-8314",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF1556096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Oaks Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Matthew William Southwick, M.D.

• Skilled Nursing Facility in Pensacola, FL
• Providers in Pensacola, 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 Apr 29, 2015; 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.