Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

A Banyan Residence at Wildwood, LLC

Organization Assisted Living Facility · NPI 1083201891

A Banyan Residence at Wildwood, LLC is an Assisted Living Facility in Oxford, Florida. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12427 County Road 101
Oxford, FL 34484-2941
Phone: (954) 854-8895
Fax: (941) 412-4749
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Assisted Living Facility (primary) Taxonomy 310400000X

Record details

NPI number1083201891
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationA Banyan Residence Assisted Living LLC
Authorized official Greg Anderson — Managing Member · (954) 536-4066
NPI enumeratedDecember 28, 2020
Last updated in NPPESDecember 28, 2020
Certification dateDecember 28, 2020
Mailing address2515 Sherman Oak Dr, North Port, FL 34289-2390

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