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

Southern Magnolia LLC

Organization Occupational Therapy Assistant · NPI 1114693579

Southern Magnolia LLC is an Occupational Therapy Assistant in Fort Myers, Florida. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
5
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

12856 Banyan Creek Dr # 2
Fort Myers, FL 33908-3082
Phone: (239) 265-5367
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X
Occupational Therapist Taxonomy 225X00000X
Pediatric Occupational Therapist Taxonomy 225XP0200X
Speech-Language Assistant Taxonomy 2355S0801X
Speech-Language Pathologist Taxonomy 235Z00000X

Record details

NPI number1114693579
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jamie Geerken — Owner · (239) 265-5367
Other names Southern Magnolia Llc; Southern Magnolia Llc
NPI enumeratedAugust 17, 2021
Last updated in NPPESFebruary 23, 2022
Certification dateFebruary 23, 2022
Mailing address17165 John Morris Rd 291, Ft Myers, FL 33908

Other providers in Fort Myers