Southern Magnolia Llc

LBN: Southern Magnolia Llc
Southern Magnolia Llc is an health care organization with primary practice located at 12856 Banyan Creek Dr # 2 , Fort Myers FL 33908-3082. The organization recently has 5 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapy Assistant, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, Speech, Language and Hearing Service Providers / Speech-Language Assistant, Speech, Language and Hearing Service Providers / Speech-Language Pathologist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapy Assistant is the primary health care specialty. Southern Magnolia Llc can be contacted via phone (239) 265-5367, or through Geerken, Jamie via phone (239) 265-5367.

Contact Information

Primary practice address
12856 Banyan Creek Dr # 2 Fort Myers FL 33908-3082
Phone: (239) 265-5367
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Geerken, Jamie Certified Occupational Therapy Assistant (COTA)
Phone: (239) 265-5367

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapy Assistant 224Z00000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X
Speech, Language and Hearing Service Providers / Speech-Language Assistant 2355S0801X
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X

Profile Details

NPI number 1114693579
LBN Legal business name Southern Magnolia Llc
DBA Doing business as Southern Magnolia Llc
Authorized official Geerken, Jamie Certified Occupational Therapy Assistant (COTA)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 17th, 2021
Last updated Feb 23rd, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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