| Entity Name: | EAGLE LAKE REHAB & NURSING, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 20 Oct 2011 (13 years ago) |
| Date of dissolution: | 11 Mar 2019 (6 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 11 Mar 2019 (6 years ago) |
| Document Number: | L11000119901 |
| FEI/EIN Number | 45-3676701 |
| Address: | 24671 US HWY 19 N, CLEARWATER, FL 33763 |
| Mail Address: | 24671 US HWY 19 N, CLEARWATER, FL 33763 |
| ZIP code: | 33763 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1164798104 | 2012-03-23 | 2012-03-23 | 1100 66TH ST N, ST PETERSBURG, FL, 337106224, US | 1100 66TH ST N, ST PETERSBURG, FL, 337106224, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 727-345-9331 |
| Fax | 7273457064 |
Authorized person
| Name | MS. LYNDA HEBBELN |
| Role | CFO |
| Phone | 7277233021 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | SNF15650961 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BLOOM, AARON S | Agent | 24671 US HWY 19 N, CLEARWATER, FL 33763 |
| Name | Role |
|---|---|
| CAREEN, LLC | Manager |
| Name | Role |
|---|---|
| EAGLE LAKE HOLDING GROUP, LLC | Managing Member |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G13000067326 | EAGLE LAKE REHAB & CARE CENTER | EXPIRED | 2013-07-03 | 2018-12-31 | No data | 24641 US HWY 19 N, CLEARWATER, FL, 33763 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2019-03-11 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-03-12 | 24671 US HWY 19 N, CLEARWATER, FL 33763 | No data |
| CHANGE OF MAILING ADDRESS | 2015-03-12 | 24671 US HWY 19 N, CLEARWATER, FL 33763 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-03-12 | 24671 US HWY 19 N, CLEARWATER, FL 33763 | No data |
| LC AMENDMENT | 2013-08-21 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2013-06-11 | BLOOM, AARON S | No data |
| LC AMENDMENT | 2013-06-11 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J13000879677 | TERMINATED | 1000000501108 | PINELLAS | 2013-04-24 | 2023-05-03 | $ 850.37 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, CLEARWATER SERVICE CENTER, 19337 US HIGHWAY 19 N STE 200, CLEARWATER FL337643149 |
| J13000537622 | TERMINATED | 1000000451799 | LEON | 2013-02-27 | 2033-03-06 | $ 300.00 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, OUT OF STATE COLLECTIONS UNIT, 1401 W US HIGHWAY 90 STE 100, LAKE CITY FL320556123 |
| J13000619263 | LAPSED | 1000000451862 | PALM BEACH | 2013-02-27 | 2023-03-27 | $ 1,581.18 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3301 N UNIVERSITY DR STE 200, CORAL SPRINGS FL330654149 |
| J13000418856 | ACTIVE | 1000000451798 | BROWARD | 2013-02-11 | 2033-02-13 | $ 1,907.64 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, OUT OF STATE COLLECTIONS UNIT, 1401 W US HIGHWAY 90 STE 100, LAKE CITY FL320556123 |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2019-03-11 |
| ANNUAL REPORT | 2018-03-18 |
| ANNUAL REPORT | 2017-01-18 |
| ANNUAL REPORT | 2016-01-20 |
| ANNUAL REPORT | 2015-03-12 |
| ANNUAL REPORT | 2014-02-04 |
| LC Amendment | 2013-08-21 |
| LC Amendment | 2013-06-11 |
| ANNUAL REPORT | 2013-04-22 |
| ANNUAL REPORT | 2012-04-27 |
Date of last update: 24 Jan 2025
Sources: Florida Department of State
