EAGLE LAKE REHAB & NURSING LLC
NPI 1164798104
Skilled Nursing Facility in St Petersburg, FL

Active since March 23, 2012
1100 66TH ST N, ST PETERSBURG, FL 33710(727) 345-9331(727) 345-7064 Get Directions Write a Review

NPPES record last updated: March 23, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Eagle Lake Rehab & Nursing Llc NPPES

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

EAGLE LAKE REHAB & NURSING LLC (NPI 1164798104) is a healthcare organization registered as a skilled nursing facility in St Petersburg, Florida and active in the NPI registry since March 2012. The organization lists Lynda Hebbeln, Cfo, as its authorized official.

NPPES Registry Identity

NPI1164798104
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameEAGLE LAKE REHAB & NURSING LLC
Location Address1100 66TH ST NSt Petersburg, FL 33710-6224
Mailing Address1100 66th St NSt Petersburg, FL 33710-6224 · (727) 345-9331 · Fax (727) 345-7064
Fax(727) 345-7064
Organization SubpartNo
Authorized OfficialLynda HebbelnCfo · (727) 723-3021
Enumeration DateMarch 23, 2012
NPI 1164798104 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in FL · SNF15650961
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
1100 66TH ST N, St Petersburg, FL 33710

Other Identifiers 1

Medicare OSCAR/certification105292

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Skilled Nursing Facility
1100 66TH ST N
ST PETERSBURG, FL 33710
Nursing Facility/Intermediate Care Facility
1100 66TH ST N
ST PETERSBURG, FL 33710
Skilled Nursing Facility
1100 66TH ST N
ST PETERSBURG, FL 33710
Social Worker (Clinical)
1100 66TH ST N
ST PETERSBURG, FL 33710
Skilled Nursing Facility
1100 66TH ST N
SAINT PETERSBURG, FL 33710
Skilled Nursing Facility
1100 66TH ST N
ST PETERSBURG, FL 33710
Physical Therapist
1100 66TH ST N
ST PETERSBURG, FL 33710

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 Eagle Lake Rehab & Nursing LLC's NPI number?

The NPI number for Eagle Lake Rehab & Nursing LLC is 1164798104. It was assigned to this organization in the NPPES registry on March 23, 2012.

Where is Eagle Lake Rehab & Nursing LLC located?

Eagle Lake Rehab & Nursing LLC is located at 1100 66th St N, St Petersburg, FL 33710. The listed phone number is (727) 345-9331.

What is Eagle Lake Rehab & Nursing LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

When was this NPI record last updated?

The NPPES record for Eagle Lake Rehab & Nursing LLC was last updated on March 23, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.