Southern Gardens FL Al Management LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SOUTHERN GARDENS FL AL MANAGEMENT LLC

Doing business as

The Gardens of Lake Alfred

Practice address

255 E Main St
Lake Alfred, FL 33850-2133

Phone

(863) 956-0411

NPI assigned

May 31, 2019

Organization subpart

No

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

Authorized official

Name

Cameron Marsh

Title

Corporate Finance

Phone

(386) 255-1054

Specialties & licenses 1

Addresses

Other names 1

• The Gardens of Lake Alfred Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1559260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559260800000",
    "number": "1356909642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 FENTRESS BLVD STE H",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321141237"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN GARDENS FL AL MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-31",
        "last_updated": "2019-05-31",
        "status": "A",
        "authorized_official_last_name": "MARSH",
        "authorized_official_first_name": "CAMERON",
        "authorized_official_title_or_position": "CORPORATE FINANCE",
        "authorized_official_telephone_number": "386-255-1054"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Gardens of Lake Alfred",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Raquel Ralat Martinez
• Andrea Don Rexroad, PTA
• Tatianna Rivera Pagan
• Zeena Satar, MSN, FNP-C
• Regina Solomon
• Southern Gardens, LLC
• Wong Family Dental Center, PA
• Anthony Ignatius Wong, DDS
• Carol Wong, DDS
• Tara Woodward, PTA

• 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 May 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.