EAGLE LAKE REHAB & NURSING, LLC
NPI 1174898605
Nursing Facility/Intermediate Care Facility in St Petersburg, FL

Active since March 16, 2012
1100 66TH ST N, ST PETERSBURG, FL 33710(727) 345-9331(727) 345-7064 Get Directions Write a Review

NPPES record last updated: April 20, 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 1174898605) is a healthcare organization registered as a nursing facility/intermediate care 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

NPI1174898605
Entity TypeOrganization
Primary Taxonomy313M00000X
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 16, 2012
Last NPPES UpdateApril 20, 2012
NPI 1174898605 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
Taxonomy Code313M00000X
License Licensed in FL · SNF15650961
Definition

An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.

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
Skilled Nursing 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 1174898605. It was assigned to this organization in the NPPES registry on March 16, 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 Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.

When was this NPI record last updated?

The NPPES record for Eagle Lake Rehab & Nursing, LLC was last updated on April 20, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.