Provider Demographics
NPI:1124343082
Name:SOUTH OAKS RETIREMENT, INC
Entity type:Organization
Organization Name:SOUTH OAKS RETIREMENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:RANDLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-549-6425
Mailing Address - Street 1:6141 SW 34TH ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-5129
Mailing Address - Country:US
Mailing Address - Phone:954-549-6425
Mailing Address - Fax:
Practice Address - Street 1:6141 SW 34TH ST
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-5129
Practice Address - Country:US
Practice Address - Phone:954-549-6425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-05
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility