Organization · Type 2 NPI

Eagle Lake Rehab & Nursing, LLC

Nursing Facility/Intermediate Care Facility · St. Petersburg, FL

NPI number 1174898605 Active

Practice location

1100 66th St N
St. Petersburg, FL 33710-6224

Call (727) 345-9331 Map

Fax (727) 345-7064

Specialties and licenses

TaxonomyCodeLicense
Nursing Facility/Intermediate Care Facility Primary 313M00000XSNF15650961 (FL)

Nursing Facility/Intermediate Care Facility: 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 conditi…

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About NPI 1174898605

Eagle Lake Rehab & Nursing, LLC's National Provider Identifier is 1174898605, issued on Mar 16, 2012. The primary taxonomy on file is Nursing Facility/Intermediate Care Facility (313M00000X), and the practice location is in St. Petersburg, FL. The record was last updated on Apr 20, 2012.