| Entity Name: | FLORIDA FAMILY RURAL HEALTH CARE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 24 Oct 2003 (21 years ago) |
| Date of dissolution: | 23 Sep 2022 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (2 years ago) |
| Document Number: | L03000040920 |
| FEI/EIN Number | 200560620 |
| Address: | 131 North Lake Reedy Blvd., Frostproof, FL, 33843, US |
| Mail Address: | PO BOX 1356, FROSTPROOF, FL, 33843 |
| ZIP code: | 33843 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1902944747 | 2007-02-02 | 2012-09-12 | 2398 HARTFORD DR, AVON PARK, FL, 338259523, US | 2398 HARTFORD DR, AVON PARK, FL, 338259523, US | |||||||||||||||||||||||||||||||||||||||
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| Phone | +1 863-453-2500 |
| Fax | 8634530745 |
Authorized person
| Name | MR. MICHAEL RAY KARR |
| Role | PRESIDENT |
| Phone | 8634532500 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| License Number | PA1725 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| License Number | ME 91882 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 660069700 |
| State | FL |
| Issuer | MEDICAID |
| Number | 290263000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Karr Ruth A | Agent | 131 North Lake Reedy Blvd., Frostproof, FL, 33843 |
| Name | Role | Address |
|---|---|---|
| KARR MICHAEL | Manager | 131 North Lake Reedy Blvd., Frostproof, FL, 33843 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G08093900118 | AVON MEDICAL CENTER | EXPIRED | 2008-04-01 | 2013-12-31 | No data | 2398 BEACH DRIVE, AVON PARK, FL, 33825 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-10-04 | 131 North Lake Reedy Blvd., Frostproof, FL 33843 | No data |
| REINSTATEMENT | 2021-10-04 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-10-04 | 131 North Lake Reedy Blvd., Frostproof, FL 33843 | No data |
| REGISTERED AGENT NAME CHANGED | 2021-10-04 | Karr, Ruth A | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| REINSTATEMENT | 2012-01-08 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2007-08-15 | 131 North Lake Reedy Blvd., Frostproof, FL 33843 | No data |
| CANCEL ADM DISS/REV | 2005-10-10 | No data | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2021-10-04 |
| ANNUAL REPORT | 2020-03-02 |
| ANNUAL REPORT | 2019-04-24 |
| ANNUAL REPORT | 2018-03-20 |
| ANNUAL REPORT | 2017-04-05 |
| ANNUAL REPORT | 2016-04-27 |
| ANNUAL REPORT | 2015-01-13 |
| ANNUAL REPORT | 2014-03-25 |
| ANNUAL REPORT | 2013-04-15 |
| REINSTATEMENT | 2012-01-08 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
