Ltcsp St. Petersburg, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SNF14800962 Issued in FL

Legal business name

LTCSP ST. PETERSBURG, LLC

Practice address

3479 54TH Ave N
St Petersburg, FL 33714-2426

Phone

(727) 527-7315

Fax

(727) 526-5887

NPI assigned

Jun 13, 2005

Organization subpart

No

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

Authorized official

Name

Howard Jaffe

Title

President

Phone

(215) 346-6454

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Long Term Care of St. Petersburg Doing business as

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349395200000",
    "number": "1740284223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 PALM BEACH LAKES BLVD",
            "address_2": "SUITE 900",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "33401",
            "telephone_number": "561-801-7600",
            "fax_number": "414-268-4811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3479 54TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337142426",
            "telephone_number": "727-527-7315",
            "fax_number": "727-526-5887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LTCSP ST. PETERSBURG, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-13",
        "last_updated": "2012-10-05",
        "status": "A",
        "authorized_official_last_name": "JAFFE",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-346-6454"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF14800962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "028190500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Long Term Care of St. Petersburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• William E Lowry, M.D.
• Tiffany Amanda Lowtan, MD
• Loyalty Home Care, Inc
• LP St. Petersburg, LLC
• LS Helping Hand LLC
• Alexander Kuang-Tsu Lu, DO
• Peggy Lubin, LCSW
• Cheryl Lynn Lucas
• Nathan R Lucas, OTR
• Rodney Daniel Lucas, M.D.

• Skilled Nursing Facility in St Petersburg, FL
• Providers in St 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 Oct 5, 2012; 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.