Organization Active NPI

Snell Island SNF LLC

  • Skilled Nursing Facility
  • St Petersburg, FL
National Provider Identifier
1356540033
Registry record updated Sep 23, 2013
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Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
SNF1499095 Issued in FL
Legal business name
SNELL ISLAND SNF LLC
Practice address
4500 Indianapolis St NE
St Petersburg, FL 33703-4317
Phone
(727) 209-4600
NPI assigned
Jul 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Tzvi Bogomilsky
Title
Authorized Official
Phone
(305) 401-7901

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X SNF1499095 FL Primary

Addresses

Primary practice location

4500 Indianapolis St NE
St Petersburg, FL 33703-4317

Mailing address

1835 NE Miami Gardens Dr
#368
North Miami Beach, FL 33179-5035

Other identifiers 1

IdentifierTypeStateIssuer
032413200MedicaidFL

Other names 1

  • Shore Acres Rehabilitation and Health Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379894400000",
    "number": "1356540033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 NE MIAMI GARDENS DR",
            "address_2": "#368",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331795035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 INDIANAPOLIS ST NE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337034317",
            "telephone_number": "727-209-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNELL ISLAND SNF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-13",
        "last_updated": "2013-09-23",
        "status": "A",
        "authorized_official_last_name": "BOGOMILSKY",
        "authorized_official_first_name": "TZVI",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "305-401-7901",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF1499095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "032413200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shore Acres Rehabilitation and Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.