LP St. Petersburg Pasadena, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

LP ST. PETERSBURG PASADENA, LLC

Doing business as

Gulfport Rehabilitation Center

Practice address

1430 Pasadena Ave S
South Pasadena, FL 33707-3716

Phone

(727) 344-8525

Fax

(855) 887-9751

NPI assigned

Nov 7, 2012

Last updated

Jan 6, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Harrison

Title

Cfo

Phone

(502) 568-7800

Specialties & licenses 1

Addresses

Other names 1

• Gulfport Rehabilitation Center Doing business as

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

{
    "created_epoch": "1352246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420502400000",
    "number": "1508110909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12201 BLUEGRASS PKWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402992361",
            "telephone_number": "502-568-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 PASADENA AVE S",
            "city": "SOUTH PASADENA",
            "state": "FL",
            "postal_code": "337073716",
            "telephone_number": "727-344-8525",
            "fax_number": "855-887-9751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LP ST. PETERSBURG PASADENA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-07",
        "last_updated": "2015-01-06",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "502-568-7800"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gulfport Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Julie Nan Lauderdale-Garzia, MS
• Darren W. Leverenz, M.D.
• Lori Marie Levin, LPN
• Alan Mark Levine, M.D.
• Lori Prince LCSW PA
• Ltcsp Pasadena, LLC (Pasadena Manor)
• Nicolas Lyde, PA
• Lindsay Macgregor
• Heather M Magee, BC-HIS
• Michael Maiello

• Skilled Nursing Facility in South Pasadena, FL
• Providers in South Pasadena, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2015; 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.