| Entity Name: | FLORIDA LIFE RECOVERY AND REHABILITATION LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 20 Mar 2017 (8 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year ago) |
| Document Number: | L17000063654 |
| FEI/EIN Number | 821294142 |
| Address: | 590 East 49th Street, HIALEAH, FL, 33013, US |
| Mail Address: | 590 East 49th Street, HIALEAH, FL, 33013, US |
| ZIP code: | 33013 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1215440227 | 2017-11-13 | 2022-12-07 | 590 E 49TH ST, HIALEAH, FL, 330131962, US | 590 E 49TH ST, HIALEAH, FL, 330131962, US | |||||||||||||||||||||
|
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| Phone | +1 305-960-7104 |
| Fax | 3059075221 |
Authorized person
| Name | ANGELICA PACHECO |
| Role | OFFICE MANAGER |
| Phone | 3059607104 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 105937600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PACHECO DANIEL Daniel | Agent | 590 East 49th Street, HIALEAH, FL, 33013 |
| Name | Role | Address |
|---|---|---|
| PACHECO DANIEL | Chief Executive Officer | 590 East 49th Street, HIALEAH, FL, 33013 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000146900 | PACHECO MEDICAL CENTERS | ACTIVE | 2022-11-30 | 2027-12-31 | No data | 590 E 49 ST, HIALEAH, FL, 33013 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| REINSTATEMENT | 2021-11-08 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-03-26 | 590 East 49th Street, HIALEAH, FL 33013 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-03-26 | 590 East 49th Street, HIALEAH, FL 33013 | No data |
| CHANGE OF MAILING ADDRESS | 2019-03-26 | 590 East 49th Street, HIALEAH, FL 33013 | No data |
| REGISTERED AGENT NAME CHANGED | 2019-03-26 | PACHECO, DANIEL, Daniel Pacheco | No data |
| REINSTATEMENT | 2018-10-08 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| LC AMENDMENT | 2017-08-15 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J24000707305 | ACTIVE | 1000001018651 | MIAMI-DADE | 2024-11-04 | 2034-11-06 | $ 1,117.59 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, MIAMI SERVICE CENTER, 3750 NW 87TH AVE STE 300, DORAL FL331782430 |
| J21000335798 | ACTIVE | 1000000893005 | DADE | 2021-06-25 | 2031-07-07 | $ 670.11 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, MIAMI SERVICE CENTER, 8175 NW 12TH ST STE 119, DORAL FL331261828 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2022-08-31 |
| REINSTATEMENT | 2021-11-08 |
| ANNUAL REPORT | 2020-06-30 |
| ANNUAL REPORT | 2019-03-26 |
| REINSTATEMENT | 2018-10-08 |
| LC Amendment | 2017-08-15 |
| Florida Limited Liability | 2017-03-20 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
