South Campus Facility Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SNF12910961 Issued in FL

Legal business name

SOUTH CAMPUS FACILITY INC

Practice address

715 E Dixie Ave
Leesburg, FL 34748-5926

Phone

(352) 728-3020

NPI assigned

Apr 28, 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

• South Campus Care Center Doing business as

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

{
    "created_epoch": "1430179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430784000000",
    "number": "1629455779",
    "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": "715 E DIXIE AVE",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485926",
            "telephone_number": "352-728-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CAMPUS FACILITY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-28",
        "last_updated": "2015-05-05",
        "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": "SNF12910961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Campus Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jason Snyder, D.M.D.
• Michel A Snyder, MD
• Susan Evata Snyder, COTA
• Christopher T Soprenuk, MD
• Amarilis Sotolongo, MSN-FNP
• South Campus Nursing and Rehab LLC
• Laura Stokes Southern, PT
• Spectacular Touch, LLC
• Hallie Spicer, PA-C
• Courtney Jamelle Spikes

• Skilled Nursing Facility in Leesburg, FL
• Providers in Leesburg, 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 May 5, 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.