| Entity Name: | CENTRAL FLORIDA CLINIC FOR REHABILITATION, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 09 Aug 1983 (41 years ago) |
| Document Number: | G54257 |
| FEI/EIN Number | 592320379 |
| Address: | 255 SE 7TH AVENUE, STE 2, CRYSTAL RIVER, FL, 34429, US |
| Mail Address: | 255 SE 7TH AVENUE, STE 2, CRYSTAL RIVER, FL, 34429, US |
| ZIP code: | 34429 |
| County: | Citrus |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1225189525 | 2007-01-15 | 2014-08-01 | 255 SE 7TH AVE, CRYSTAL RIVER, FL, 344294891, US | 255 SE 7TH AVE, CRYSTAL RIVER, FL, 344294891, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 352-795-4114 |
| Fax | 3525632438 |
Authorized person
| Name | MRS. MADELINE GERRITS BROWN |
| Role | ADMINISTRATOR-OWNER |
| Phone | 3527954114 |
Taxonomy
| Taxonomy Code | 261QR0400X - Rehabilitation Clinic/Center |
| License Number | HCCR2624 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | FIRST HEALTH |
| Number | 1737737 |
| State | FL |
| Issuer | PEDIACARE |
| Number | C178 |
| State | FL |
| Issuer | MED WAIVER-ADEPT |
| Number | 671853196 |
| State | FL |
| Issuer | MEDICAID |
| Number | 880658600 |
| State | FL |
| Issuer | HEALTHEASE |
| Number | 168089 |
| State | FL |
| Issuer | A VMED |
| Number | 101374-0379 |
| State | FL |
| Issuer | NETWORK SYNERGY |
| Number | 920841-2051 |
| State | FL |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | R90 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BROWN, MADELINE G. | Agent | 255 SE 7TH AVENUE, CRYSTAL RIVER, FL, 34429 |
| Name | Role | Address |
|---|---|---|
| BROWN MADELINE | President | 255 SE 7TH AVENUE, CRYSTAL RIVER, FL, 34429 |
| Name | Role | Address |
|---|---|---|
| BROWN MADELINE | Director | 255 SE 7TH AVENUE, CRYSTAL RIVER, FL, 34429 |
| Brown Christopher S | Director | 255 SE 7TH AVENUE, CRYSTAL RIVER, FL, 34429 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
