Eagle Lake Nursing & Rehab Opco LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

EAGLE LAKE NURSING & REHAB OPCO LLC

Practice address

1100 66TH St N
Saint Petersburg, FL 33710-6224

Phone

(727) 345-9331

NPI assigned

Mar 1, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Eden Najman

Title

C.E.O.

Phone

(786) 785-9156

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Skilled nursing facility certification: CCN 105292

Legal name

EAGLE LAKE NURSING & REHAB OPCO LLC

Doing business as

EAGLE LAKE NURSING AND REHAB CARE CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jan 7, 1976

Last certification

Aug 29, 2024

Beds

59

Ownership / control type

Limited Liability Corporation

Multi-facility organization

HCO Management

Most recent change of ownership

Feb 1, 2024

Organization structure

LLCProprietary

Enrollment address

1100 66TH St N
Hillsborough, FL 33710-6224

Nursing home name

EAGLE LAKE NURSING AND REHAB CARE CENTER

Affiliated entity

BLUE RIDGE HEALTHCARE

Listed as

Eagle Lake Nursing and Rehab Care CenterCCN 105292 · All quality measures

Overall star rating

1 of 5

Health inspections

1 of 5

Staffing

3 of 5

Quality measures

1 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Jan 7, 1976

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

5936.0 residents per day on average

Chain

Blue Ridge Healthcare3 facilities in the chain

Penalties (3 years)

2Fines totaling $312,600

Processed by Care Compare on Aug 1, 2026.

Locations

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Fadi Saba, M.D.

  • Internal Medicine Physician
  • St Petersburg, FL
  • NPI 1588658348

  Adp of the SNF

  CMS ownership

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Dino C Romero, MD

  • General Practice Physician
  • Parrish, FL
  • NPI 1730766114

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1709251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709251200000",
    "number": "1578320172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7951 SW 6TH ST STE 116",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333243211",
            "telephone_number": "786-785-9165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 66TH ST N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337106224",
            "telephone_number": "727-345-9331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE LAKE NURSING & REHAB OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-01",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A",
        "authorized_official_last_name": "NAJMAN",
        "authorized_official_first_name": "EDEN",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "786-785-9156",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Dziopala
• Joy Dziopala, ARNP
• E & S Family Medicine Physicians
• E Therapy Staffing Solutions
• Eagle Lake Foundation Inc
• Eagle Lake Opco LLC
• Eagle Lake Rehab & Nursing LLC
• Eagle Lake Rehab & Nursing, LLC
• Jane Eagle
• Joanne Eames, APRN

• Skilled Nursing Facility in Saint Petersburg, FL
• Providers in Saint Petersburg, 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 Mar 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.