| Entity Name: | ATLANTIC COAST MEDICAL REHAB, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 23 Jul 2007 (18 years ago) |
| Document Number: | L07000075991 |
| FEI/EIN Number | 260599492 |
| Address: | 13171 Atlantic Blvd, JACKSONVILLE, FL, 32225, US |
| Mail Address: | 13171 Atlantic Blvd, JACKSONVILLE, FL, 32225, US |
| ZIP code: | 32225 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1104115112 | 2011-03-30 | 2020-06-29 | 13171 ATLANTIC BLVD. SUITE #100, JACKSONVILLE, FL, 32225, US | 13171 ATLANTIC BLVD. SUITE #100, JACKSONVILLE, FL, 32225, US | |||||||||||||||||||||||||
|
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| Phone | +1 904-888-6095 |
| Fax | 9042805238 |
Authorized person
| Name | TRACI ROSENSTEIN |
| Role | ADMINISTRATOR |
| Phone | 9048886095 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | ME79945 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 001KM |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HAYES DENNIS E | Agent | 2320 THE WOODS DR. WEST, JACKSONVILLE, FL, 32246 |
| Name | Role | Address |
|---|---|---|
| ROSENSTEIN SCOTT | Managing Member | 149 SEA LILY LN, PONTE VEDRA BEACH, FL, 32082 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2017-03-21 | 13171 Atlantic Blvd, STE 100, JACKSONVILLE, FL 32225 | No data |
| CHANGE OF MAILING ADDRESS | 2017-03-21 | 13171 Atlantic Blvd, STE 100, JACKSONVILLE, FL 32225 | No data |
| REGISTERED AGENT NAME CHANGED | 2010-04-21 | HAYES, DENNIS ESQ. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-04-21 | 2320 THE WOODS DR. WEST, JACKSONVILLE, FL 32246 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-04-11 |
| ANNUAL REPORT | 2022-04-21 |
| ANNUAL REPORT | 2021-02-12 |
| ANNUAL REPORT | 2020-04-14 |
| ANNUAL REPORT | 2019-03-12 |
| ANNUAL REPORT | 2018-01-30 |
| ANNUAL REPORT | 2017-03-21 |
| ANNUAL REPORT | 2016-02-03 |
| ANNUAL REPORT | 2015-04-27 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
