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BANYAN GULF BREEZE LLC
NPI 1033899372
Substance Abuse Rehabilitation Facility in Gulf Breeze, FL

Active since July 21, 2023CLIA Certified · 2 labs
4400 HICKORY SHORES BLVD, GULF BREEZE, FL 32563(954) 533-7705(754) 206-8522 Get Directions Write a Review

NPPES record last updated: May 13, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 13, 2025, Jul 9, 2024, Jun 20, 2024 and 1 more (4 updates tracked since 2023).

About Banyan Gulf Breeze Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BANYAN GULF BREEZE LLC (NPI 1033899372) is a healthcare organization registered as a substance abuse rehabilitation facility in Gulf Breeze, Florida and active in the NPI registry since July 2023. The organization holds 2 active CLIA laboratory certificates and lists John Sory, Ceo, as its authorized official.

NPPES Registry Identity

NPI1033899372
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameBANYAN GULF BREEZE LLC
Location Address4400 HICKORY SHORES BLVDGulf Breeze, FL 32563-9111
Mailing Address225 N Federal HwyPompano Beach, FL 33062-4319 · Fax (954) 781-7173
Phone(954) 533-7705
Fax(754) 206-8522
Organization SubpartNo
Authorized OfficialJohn SoryCeo · (954) 533-7705
Enumeration DateJuly 21, 2023
Last NPPES UpdateMay 13, 20254 updates tracked since enumeration
NPPES CertifiedMay 13, 2025
✔ NPI 1033899372 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
Also ListedPsychiatric HospitalTaxonomy 283Q00000X
4400 HICKORY SHORES BLVD, Gulf Breeze, FL 32563
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Other Identifiers 1

Medicaid122548100FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Wellpoint.Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2291588

Banyan Gulf Breeze LLC · Gulf Breeze, FL
Active · expires Oct 11, 2027
CLIA Number10D2291588
Laboratory TypeSud Treatment Center
Certificate Effective DateOctober 12, 2025
Certificate Expiration DateOctober 11, 2027
Laboratory DirectorSherilyn L. Toro
Laboratory Phone(954) 533-7705
Laboratory LocationBanyan Gulf Breeze LLC4400 Hickory Shores Blvd, Gulf Breeze, FL 32563
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D2321090

Banyan Gulf Breeze LLC · Gulf Breeze, FL
Active · expires Mar 27, 2027
CLIA Number10D2321090
Laboratory TypeSud Treatment Center
Certificate Effective DateMarch 28, 2025
Certificate Expiration DateMarch 27, 2027
Laboratory DirectorSherilyn Toro
Laboratory Phone(954) 533-7705
Laboratory LocationBanyan Gulf Breeze LLC1070 Bayshore Road, Gulf Breeze, FL 32563
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Banyan Gulf Breeze LLC's NPI number?

The NPI number for Banyan Gulf Breeze LLC is 1033899372. It was assigned to this organization in the NPPES registry on July 21, 2023.

Where is Banyan Gulf Breeze LLC located?

Banyan Gulf Breeze LLC is located at 4400 Hickory Shores Blvd, Gulf Breeze, FL 32563. The listed phone number is (954) 533-7705.

What is Banyan Gulf Breeze LLC's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

Does Banyan Gulf Breeze LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Banyan Gulf Breeze LLC accept?

Health plans from Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Wellpoint list Banyan Gulf Breeze LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Banyan Gulf Breeze LLC was last updated on May 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.