OrganizationActive
Eagle Lake Rehab & Nursing, LLC
NPI 1174898605 · Nursing Facility/Intermediate Care Facility · St Petersburg, FL
Provider details
- NPI number
- 1174898605
- Entity type
- Organization
- Primary specialty
- Nursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Lynda Hebbeln, Cfo(727) 723-3021
- License
- SNF15650961 (FL)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
1100 66th St N
St Petersburg, FL 33710-6224
Phone: (727) 345-9331
Fax: (727) 345-7064
Approximate (ZIP-level) locationGet directions
Mailing address
1100 66th St N
St Petersburg, FL 33710-6224
Registry dates
- Enumerated
- 2012-03-16
- Last updated
- 2012-04-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.