MRS. MARY SOUTHWELL (NPI# 1811353782) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811353782 |
| Entity Type | Individual |
| Full Name | MRS. MARY SOUTHWELL |
| Practice Address |
2601 Campus Hill Dr Tampa FL 33612-4722 |
| Mailing Address |
1472 Lake Shore Ranch Dr Seffner FL 33584-5562 |
| Practice Telephone | 8139788203 |
| Practice Fax Number | 8139788203 |
| Mailing Telephone | 8135032441 |
| Mailing Fax Number | 8139788203 |
| Enumeration Date | 2016-01-07 |
| Last Update Date | 2016-01-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | AL12719 | FL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 015721500 | 05 |
| Street Address |
2601 CAMPUS HILL DR |
| City | TAMPA |
| State | FL |
| Zip Code | 33612-4722 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811512338 | Boykins Group LLC | Assisted Living Facility | 2601 Campus Hill Dr, Tampa, FL 33612-3361 | 2020-06-10 |
| 1598321531 | Latonia Boykins | Assisted Living Facility | 2601 Campus Hill Dr, Tampa, FL 33612-4722 | 2019-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689286767 | Daniel Jimenez | Physical Therapist | 13000 Bruce B Downs Blvd, Tampa, Fl, Tampa, FL 33612 | 2020-08-19 |
| 1700426830 | Taz Stacy | Behavior Technician | 2701 University Square Drive, Tampa, FL 33612 | 2020-01-07 |
| 1841853215 | Eric Austen Keeler | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd, Mdc5, Tampa, FL 33612 | 2019-04-20 |
| 1346700242 | Caitlyn Victoria Cartwright | Student in an Organized Health Care Education/Training Program | 12901 Bruce B. Downs Blvd., Mdc5, Tampa, FL 33612 | 2019-03-25 |
| 1720552953 | Marijo Bilitski | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd # Blvd5, Tampa, FL 33612 | 2019-01-22 |
| 1790259190 | Belkis Aleman | Nurse Practitioner | 205 E Busch Blvd, Tampa, FL 33612 | 2019-01-18 |
| 1811469133 | Stephanie Stegner | Physician Assistant | 12901 Bruce B Downs Blvd Mdc 5, Tampa, FL 33612 | 2018-12-27 |
| 1053889857 | Alysia Heather Siegel | Psychologist | 1300 Bruce B. Downs Boulevard, 116b, Tampa, FL 33612 | 2018-11-09 |
| 1295202489 | Daisy Baby Pulinilkumkalayil | Nurse Practitioner | 1426 W. Bush Blvd. Suite #105, Suite #105, Tampa, FL 33612 | 2018-10-26 |
| 1649745258 | Rachel Rene Shelton | Specialist/Technologist | Orthopedics and Sports Medicine, 13330 Usf Laurel Drive, Tampa, FL 33612 | 2018-10-10 |
| Find all providers in zip 33612 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831704980 | Ocean Breeze Alf LLC | Assisted Living Facility | 4713 Kelly Rd, Tampa, FL 33615-5018 | 2020-09-14 |
| 1770191082 | Twala Neia Atwood | Assisted Living Facility | 3111 W Napoleon Ave, Tampa, FL 33611-5222 | 2020-07-22 |
| 1568080075 | Loving Health Care, Corp II | Assisted Living Facility | 4817 Ridge Point Dr, Tampa, FL 33624-6325 | 2020-07-10 |
| 1063036481 | La Rosa Alf Corp | Assisted Living Facility | 1615 Carnegie Cir, Tampa, FL 33619-5621 | 2020-06-01 |
| 1538783261 | L&y Paradise Alf Corp | Assisted Living Facility | 14314 Capitol Dr, Tampa, FL 33613-2116 | 2020-05-28 |
| 1205467107 | Bella Vita Alf At Latania LLC | Assisted Living Facility | 3413 Latania Dr, Tampa, FL 33618-4759 | 2020-01-29 |
| 1689213605 | Haven Alf, Inc. | Assisted Living Facility | 1514 Haven Bnd, Tampa, FL 33613-1133 | 2019-12-23 |
| 1194362491 | Sh Carrollwood, LLC | Assisted Living Facility | 13550 S Village Dr, Tampa, FL 33618-8420 | 2019-12-05 |
| 1235772062 | Bella Vita Assisted Living Community | Assisted Living Facility | 13202 Lake Magdalene Blvd, Tampa, FL 33618-3008 | 2019-10-24 |
| 1912549296 | Galaad Alf Corp | Assisted Living Facility | 7508 Clearview Dr, Tampa, FL 33634-2930 | 2019-10-08 |
| Find all providers in TAMPA | ||||
Please comment or provide details below to improve the information on MRS. MARY SOUTHWELL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.