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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MASONIC HOME OF FLORIDA INC
NPI 1902587876
Skilled Nursing Facility in St Petersburg, FL

Active since July 25, 2023CLIA 10D0025442 · Waiver
3201 1ST ST NE, ST PETERSBURG, FL 33704(727) 822-3499(727) 821-6775 Get Directions Write a Review

NPPES record last updated: September 19, 2026. Verified against the NPPES registry weekly; last sync: September 20, 2026.

Record update history: Sep 19, 2026, Jul 25, 2023 (2 updates tracked since 2023).

About Masonic Home Of Florida Inc NPPES

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

MASONIC HOME OF FLORIDA INC (NPI 1902587876) is a healthcare organization registered as a skilled nursing facility in St Petersburg, Florida and active in the NPI registry since July 2023. The organization holds a CLIA Waiver certificate valid through August 31, 2028 and lists Kimberley Mcfadden, Administrator, as its authorized official.

NPPES Registry Identity

NPI1902587876
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameMASONIC HOME OF FLORIDA INC
Location Address3201 1ST ST NESt Petersburg, FL 33704-2299
Mailing Address3201 1st St NeSt Petersburg, FL 33704-2299 · (727) 822-3499 · Fax (727) 821-6775
Phone(727) 822-3499
Fax(727) 821-6775
Organization SubpartNo
Authorized OfficialKimberley McfaddenAdministrator · (727) 822-3499
Enumeration DateJuly 25, 2023
Last NPPES UpdateSeptember 19, 20262 updates tracked since enumeration
NPPES CertifiedSeptember 19, 2026
✔ NPI 1902587876 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
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.
Also ListedAssisted Living FacilityTaxonomy 310400000X
3201 1ST ST NE, St Petersburg, FL 33704
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CLIA Laboratory Certificates CMS CLIA

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 10D0025442

Masonic Home Of Florida,the · Saint Petersburg, FL
Active · expires Aug 31, 2028
CLIA Number10D0025442
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2026
Certificate Expiration DateAugust 31, 2028
Laboratory DirectorNora Pearson
Laboratory Phone(727) 822-3499
Laboratory LocationMasonic Home Of Florida,the3201 1st St NE, Saint Petersburg, FL 33704
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

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

MELISSA RENEE COSSER
Speech-Language Pathologist
3201 1ST ST NE
ST PETERSBURG, FL 33704
Pinellas County (727) 822-3499
JENNA TAYLOR
Occupational Therapist
3201 1ST ST NE
SAINT PETERSBURG, FL 33704
Pinellas County (727) 822-3499
MISS WENDY NAN CRISWELL SLP
Speech-Language Pathologist
3201 1ST ST NE
ST PETERSBURG, FL 33704
Pinellas County (727) 822-3499
MR. JOSELITO COLMENARES REYNES PHYSICAL THERAPIST
Physical Therapist
3201 1ST ST NE
ST PETERSBURG, FL 33704
Pinellas County (727) 822-3499
REHAB THERAPY OUTCOMES LLC
Physical Therapist
3201 1ST ST NE
ST PETERSBURG, FL 33704
Pinellas County (727) 822-3499

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 Masonic Home Of Florida Inc's NPI number?

The NPI number for Masonic Home Of Florida Inc is 1902587876. It was assigned to this organization in the NPPES registry on July 25, 2023.

Where is Masonic Home Of Florida Inc located?

Masonic Home Of Florida Inc is located at 3201 1st St NE, St Petersburg, FL 33704. The listed phone number is (727) 822-3499.

What is Masonic Home Of Florida Inc's specialty?

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

Does Masonic Home Of Florida Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D0025442) is associated with this NPI, valid through August 31, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Masonic Home Of Florida Inc was last updated on September 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 days 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.