| Entity Name: | KEY WEST HEALTH AND REHABILITATION CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 17 Apr 2009 (16 years ago) |
| Date of dissolution: | 24 Sep 2021 (3 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2021 (3 years ago) |
| Document Number: | L09000037122 |
| FEI/EIN Number | 264689618 |
| Address: | 1240 MARBELLA PLAZA DRIVE, TAMPA, FL, 33619, US |
| Mail Address: | 1240 MARBELLA PLAZA DRIVE, TAMPA, FL, 33619, US |
| ZIP code: | 33619 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982838330 | 2009-05-13 | 2011-07-26 | 1240 MARBELLA PLAZA DR, TAMPA, FL, 336197906, US | 5860 W JUNIOR COLLEGE RD, KEY WEST, FL, 330404314, US | |||||||||||||||||||||||||||
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| Phone | +1 813-341-2700 |
| Fax | 8136760126 |
Authorized person
| Name | MR. ROBERT DANIEL VAUGHAN |
| Role | PRESIDENT |
| Phone | 8133412700 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 002416700 |
| State | FL |
| Issuer | BLUE CROSS |
| Number | KA0 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Vaughan Michelle | Agent | 1240 MARBELLA PLAZA DRIVE, TAMPA, FL, 33619 |
| Name | Role | Address |
|---|---|---|
| SENIOR CARE GROUP, INC. | Managing Member | 1240 MARBELLA PLAZA DRIVE, TAMPA, FL, 33619 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G09000173984 | KEY WEST HEALTH AND REHABILITATION CENTER | EXPIRED | 2009-11-10 | 2024-12-31 | No data | 1240 MARBELLA PLAZA DRIVE, TAMPA, FL, 33619 |
| G09107900340 | KEY WEST HEALTH AND REHABILITATION | EXPIRED | 2009-04-17 | 2024-12-31 | No data | 1240 MARBELLA PLAZA DRIVE, TAMPA, FL, 33619 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2018-02-20 | Vaughan, Michelle | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2020-06-22 |
| ANNUAL REPORT | 2019-03-28 |
| ANNUAL REPORT | 2018-02-20 |
| ANNUAL REPORT | 2017-04-14 |
| ANNUAL REPORT | 2016-01-13 |
| ANNUAL REPORT | 2015-02-23 |
| ANNUAL REPORT | 2014-04-11 |
| ANNUAL REPORT | 2013-04-10 |
| ANNUAL REPORT | 2012-01-04 |
| ANNUAL REPORT | 2011-01-05 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
