| Entity Name: | KALIE REHABILITATION MEDICINE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 24 Apr 2023 (2 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 28 Aug 2023 (a year ago) |
| Document Number: | L23000202389 |
| FEI/EIN Number | 92-3699575 |
| Address: | 90 Kenmore Ave, Ponte Vedra, FL 32081 |
| Mail Address: | 90 Kenmore Ave, Ponte Vedra, FL 32081 |
| ZIP code: | 32081 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1053090043 | 2023-07-17 | 2024-01-17 | 90 KENMORE AVE, PONTE VEDRA, FL, 320810100, US | 90 KENMORE AVE, PONTE VEDRA, FL, 320810100, US | |||||||||||||
|
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| Phone | +1 330-465-3587 |
Authorized person
| Name | BLAKE KALIE |
| Role | PRESIDENT |
| Phone | 3304653587 |
Taxonomy
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| KALIE, KATIE | Agent | 90 KENMORE AVENUE, PONTE VEDRA, FL 32081 |
| Name | Role | Address |
|---|---|---|
| KATIE, KALIE | Manager | 90 KENMORE AVENUE, PONTE VEDRA, FL 32081 |
| Name | Role | Address |
|---|---|---|
| Kalie, Blake | Chief Executive Officer | 90 Kenmore Ave, Ponte Vedra, FL 32081 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2023-08-28 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2023-08-28 | KALIE, KATIE | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-08-28 | 90 KENMORE AVENUE, PONTE VEDRA, FL 32081 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-07-25 | 90 Kenmore Ave, Ponte Vedra, FL 32081 | No data |
| CHANGE OF MAILING ADDRESS | 2023-07-25 | 90 Kenmore Ave, Ponte Vedra, FL 32081 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-12 |
| LC Amendment | 2023-08-28 |
| Florida Limited Liability | 2023-04-24 |
Date of last update: 10 Feb 2025
Sources: Florida Department of State
