| Entity Name: | ELITE PHYSICAL MEDICINE AND REHABILITATION, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 16 Oct 2017 (7 years ago) |
| Document Number: | L17000213857 |
| FEI/EIN Number | 82-3235836 |
| Address: | 185 Sedona Way, Palm Beach Gardens, FL 33418 |
| Mail Address: | 185 Sedona Way, Palm Beach Gardens, FL 33418 |
| ZIP code: | 33418 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1750883575 | 2018-03-07 | 2018-03-07 | 153 VIA CONDADO WAY, PALM BEACH GARDENS, FL, 334181703, US | 5850 SE COMMUNITY DR, STUART, FL, 349976420, US | |||||||||||||||||||||||||||
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| Phone | +1 954-439-0244 |
| Phone | +1 772-324-3500 |
Authorized person
| Name | DR. BENJAMIN MENDELSOHN |
| Role | PHYSICIAN |
| Phone | 9493629503 |
Taxonomy
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NPI |
| Number | 1720498223 |
| State | FL |
| Issuer | INDIVIDUAL NPI |
| Number | 1720498223 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MENDELSOHN, BENJAMIN A | Agent | 185 Sedona way, Palm Beach Gardens, FL 33418 |
| Name | Role | Address |
|---|---|---|
| MENDELSOHN, BENJAMIN A | Manager | 185 Sedona Way, Palm Beach Gardens, FL 33418 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-02-18 | 185 Sedona Way, Palm Beach Gardens, FL 33418 | No data |
| CHANGE OF MAILING ADDRESS | 2024-02-18 | 185 Sedona Way, Palm Beach Gardens, FL 33418 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-18 | 185 Sedona way, Palm Beach Gardens, FL 33418 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-18 |
| ANNUAL REPORT | 2023-02-05 |
| ANNUAL REPORT | 2022-03-31 |
| ANNUAL REPORT | 2021-03-14 |
| ANNUAL REPORT | 2020-02-23 |
| ANNUAL REPORT | 2019-02-12 |
| ANNUAL REPORT | 2018-04-02 |
| Florida Limited Liability | 2017-10-16 |
Date of last update: 17 Feb 2025
Sources: Florida Department of State
