| Entity Name: | KOOL KIDS CLUB REHABILITATION CENTER LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 18 Oct 2011 (13 years ago) |
| Date of dissolution: | 19 Mar 2021 (4 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 19 Mar 2021 (4 years ago) |
| Document Number: | L11000118863 |
| FEI/EIN Number | 45-3625765 |
| Address: | 6934 SW 114 PL, UNIT H, MIAMI, FL 33173 |
| Mail Address: | 6934 SW 114 PL, UNIT H, MIAMI, FL 33173 |
| ZIP code: | 33173 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1487930137 | 2011-10-26 | 2011-10-26 | 6934 SW 114TH PL APT H, MIAMI, FL, 331731876, US | 6934 SW 114TH PL APT H, MIAMI, FL, 331731876, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 786-412-2538 |
Authorized person
| Name | MR. DEREK COLL |
| Role | PRESIDENT/OCCUPATIONAL THERAPIST |
| Phone | 7864122538 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| License Number | PT23932 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 225X00000X - Occupational Therapist |
| License Number | OT12161 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | INDIVIDUAL NPI |
| Number | 1871800599 |
| State | FL |
| Issuer | INDIVIDUAL NPI |
| Number | 1609048230 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| COLL, DEREK | Agent | 6934 SW 114 PL, UNIT H, MIAMI, FL 33173 |
| Name | Role | Address |
|---|---|---|
| COLL, DEREK | Managing Member | 6934 SW 114 PL UNIT H, MIAMI, FL 33173 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2021-03-19 | No data | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2021-03-19 |
| ANNUAL REPORT | 2020-06-30 |
| ANNUAL REPORT | 2019-03-22 |
| ANNUAL REPORT | 2018-02-27 |
| ANNUAL REPORT | 2017-03-27 |
| ANNUAL REPORT | 2016-04-25 |
| ANNUAL REPORT | 2015-02-28 |
| ANNUAL REPORT | 2014-03-28 |
| ANNUAL REPORT | 2013-02-26 |
| ANNUAL REPORT | 2012-04-22 |
Date of last update: 24 Jan 2025
Sources: Florida Department of State
