Provider Demographics
NPI:1386788495
Name:SOUTHERN HEALTH PARTNERS, INC.
Entity type:Organization
Organization Name:SOUTHERN HEALTH PARTNERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:KUDA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:850-785-5475
Mailing Address - Street 1:705 JENKS AVE
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401-2529
Mailing Address - Country:US
Mailing Address - Phone:850-785-5475
Mailing Address - Fax:850-785-5474
Practice Address - Street 1:705 JENKS AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-2529
Practice Address - Country:US
Practice Address - Phone:850-785-5475
Practice Address - Fax:850-785-5474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care