| Entity Name: | INTEGRATED REHAB CONSULTANTS FLORIDA, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 03 Dec 2018 (6 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 21 Aug 2019 (5 years ago) |
| Document Number: | L18000277180 |
| FEI/EIN Number | 83-2699887 |
| Address: | 401 N MICHIGAN AVE, STE 1200, CHICAGO, IL, 60611, US |
| Mail Address: | PO Box 7410884, CHICAGO, IL, 60674-0884, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245700244 | 2018-12-03 | 2024-07-26 | PO BOX 7410884, CHICAGO, IL, 606740884, US | 1099 W TOWN PKWY, ALTAMONTE SPG, FL, 327143845, US | |||||||||||||||||||||||||
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| Phone | +1 312-635-0973 |
| Fax | 3126350050 |
| Phone | +1 725-710-9237 |
| Fax | 7029759560 |
Authorized person
| Name | JACQUIE MCCONNELL |
| Role | MANAGER |
| Phone | 7257109237 |
Taxonomy
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 103346700 |
| State | FL |
| Name | Role |
|---|---|
| COGENCY GLOBAL INC. | Agent |
| Name | Role | Address |
|---|---|---|
| PATEL AMISH | Manager | 401 N MICHIGAN AVE, STE 1200, CHICAGO, IL, 60611 |
| Name | Role | Address |
|---|---|---|
| Ray Matt | Officer | 401 N MICHIGAN AVE, STE 1200, CHICAGO, IL, 60611 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000153771 | MEDRINA | ACTIVE | 2022-12-14 | 2027-12-31 | No data | 401 N MICHIGAN AVE, STE 1200, CHICAGO, IL, 60611 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-04-16 | 401 N MICHIGAN AVE, STE 1200, CHICAGO, IL 60611 | No data |
| LC STMNT OF RA/RO CHG | 2019-08-21 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2019-08-21 | COGENCY GLOBAL INC. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-08-21 | 115 NORTH CALHOUN ST., SUITE 4, TALLAHASSEE, FL 32301 | No data |
| LC AMENDMENT | 2019-08-13 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-16 |
| ANNUAL REPORT | 2023-04-11 |
| ANNUAL REPORT | 2022-04-27 |
| ANNUAL REPORT | 2021-04-27 |
| ANNUAL REPORT | 2020-04-13 |
| CORLCRACHG | 2019-08-21 |
| LC Amendment | 2019-08-13 |
| ANNUAL REPORT | 2019-08-06 |
| Florida Limited Liability | 2018-12-03 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
