South Daytona Health Care Associates LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SNF1122096 Issued in FL

Legal business name

SOUTH DAYTONA HEALTH CARE ASSOCIATES LLC

Doing business as

Oaktree Healthcare

Practice address

650 Reed Canal Rd
South Daytona, FL 32119-3230

Phone

(386) 767-4831

Fax

(386) 767-8253

NPI assigned

May 25, 2006

Organization subpart

No

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

Authorized official

Name

Cheryl A. Fredsall

Title

Manager

Phone

(386) 767-4831

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Oaktree Healthcare Doing business as

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343865600000",
    "number": "1346296118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 REED CANAL RD",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321193230",
            "telephone_number": "386-767-4831",
            "fax_number": "386-767-8253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 REED CANAL RD",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321193230",
            "telephone_number": "386-767-4831",
            "fax_number": "386-767-8253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH DAYTONA HEALTH CARE ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2012-08-02",
        "status": "A",
        "authorized_official_last_name": "FREDSALL",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "386-767-4831"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF1122096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025247600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oaktree Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bradford Smith
• Mark Smith, LCSW
• Rebecca Smith
• Sonus-USA, Inc
• Laura M Sosa Rodriguez
• Sarah Spearin
• Mark Spradley, D.C.
• Bonnie Stanford
• Joann Lorae Stanger, OTR
• Tasheema Sueing, PTA

• Skilled Nursing Facility in South Daytona, FL
• Providers in South Daytona, 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 Aug 2, 2012; 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.