| Entity Name: | SOUTHERN REHABILITATION GROUP LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
SOUTHERN REHABILITATION GROUP LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 06 Nov 2018 (6 years ago) |
| Date of dissolution: | 25 Sep 2020 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2020 (5 years ago) |
| Document Number: | L18000260022 |
| FEI/EIN Number |
83-2547103
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 6447 MIAMI LAKES DR, MIAMI LAKES, FL, 33014, US |
| Mail Address: | 6871 SW 129TH, MIAMI, FL, 33183, US |
| ZIP code: | 33014 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1104489079 | 2019-04-17 | 2019-04-17 | 6447 MIAMI LAKES DR E STE 200E, MIAMI LAKES, FL, 330142706, US | 6447 MIAMI LAKES DR E STE 200E, MIAMI LAKES, FL, 330142706, US | |||||||||||||||||||
|
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| Phone | +1 786-319-0748 |
Authorized person
| Name | VIVIAN BLANCO LEZCANO |
| Role | OWNER |
| Phone | 7863190748 |
Taxonomy
| Taxonomy Code | 261QD1600X - Developmental Disabilities Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 747907 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BOFFILL-SENDRANS MARTHA | Vice President | 649 W 36TH STREET, HIALEAH, FL, 33012 |
| OLAZARRA RODRIGUEZ GABRIEL | Secretary | 6871 SW 129TH AVE, MIAMI, FL, 33183 |
| LEZCANO VIVIAN B | President | 6871 SW 129TH AVE, MIAMI, FL, 33183 |
| BLANCO LEZCANO VIVIAN | Agent | 6447 MIAMI LAKES DR, MIAMI LAKES, FL, 33014 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2019-04-23 | 6447 MIAMI LAKES DR, SUITE 200 E, MIAMI LAKES, FL 33014 | - |
| CHANGE OF MAILING ADDRESS | 2019-04-23 | 6447 MIAMI LAKES DR, SUITE 200 E, MIAMI LAKES, FL 33014 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2019-04-23 | 6447 MIAMI LAKES DR, SUITE 200 E, MIAMI LAKES, FL 33014 | - |
| LC AMENDMENT | 2019-01-11 | - | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2019-04-23 |
| LC Amendment | 2019-01-11 |
| Florida Limited Liability | 2018-11-06 |
Date of last update: 01 Apr 2025
Sources: Florida Department of State
