Search icon

FORT WALTON REHABILITATION CENTER, LLC

Company Details

Entity Name: FORT WALTON REHABILITATION CENTER, LLC
Jurisdiction: FLORIDA
Filing Type: Foreign Limited Liability Company
Status: Active
Date Filed: 28 Oct 2011 (13 years ago)
Document Number: M11000005438
FEI/EIN Number 37-1651002
Mail Address: 101 Sunnytown Road, Suite 201, Casselberry, FL 32707
Address: 1 LBJ SR Drive, Fort Walton Beach, FL 32547
ZIP code: 32547
County: Okaloosa
Place of Formation: DELAWARE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1962788646 2011-10-26 2014-09-29 5887 GLENRIDGE DR, SUITE 150, ATLANTA, GA, 303285574, US 1 L B J SR DR, FORT WALTON BEACH, FL, 325471163, US

Contacts

Phone +1 404-574-2100
Fax 4045742105
Phone +1 850-863-2066
Fax 8508639006

Authorized person

Name MR. R. MARK CRONQUIST
Role MANAGER
Phone 4045742100

Taxonomy

Taxonomy Code 314000000X - Skilled Nursing Facility
State FL
Is Primary No
Taxonomy Code 314000000X - Skilled Nursing Facility
License Number SNF11610951
State FL
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number 004488800
State FL

Agent

Name Role
COGENCY GLOBAL INC. Agent

MANAGER

Name Role
SOUTHERN HEALTHCARE MANAGEMENT, LLC MANAGER

manager

Name Role
SOUTHERN HEALTHCARE MANAGEMENT, LLC manager

managed)

Name Role
SOUTHERN HEALTHCARE MANAGEMENT, LLC managed)

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2019-03-21 1 LBJ SR Drive, Fort Walton Beach, FL 32547 No data
CHANGE OF PRINCIPAL ADDRESS 2017-03-30 1 LBJ SR Drive, Fort Walton Beach, FL 32547 No data
REGISTERED AGENT ADDRESS CHANGED 2015-07-07 115 North Calhoun St., Suite 4, Tallahassee, FL 32301 No data

Court Cases

Title Case Number Docket Date Status
THE ESTATE OF ETHELEENE GALLOWAY GORDON, ETC. VS FORT WALTON REHABILITATION CENTER, LLC, ET AL. SC2022-0962 2022-07-25 Closed
Classification Discretionary Review - Notice to Invoke - Direct Conflict of Decisions
Court Supreme Court of Florida
Originating Court Circuit Court for the First Judicial Circuit, Okaloosa County
1D20-2930

Circuit Court for the First Judicial Circuit, Okaloosa County
462018CA004315CXXXXX

Parties

Name Estate of Etheleene Galloway Gordon
Role Petitioner
Status Active
Representations Mr. Michael K. Beck, Ms. Lisa M. Tanaka
Name Shervon Tanyika Thomas
Role Petitioner
Status Active
Name R. Mark Cronquist
Role Petitioner
Status Active
Name SOVEREIGN HEALTHCARE DISBURSEMENTS, LLC
Role Respondent
Status Active
Name MARUTI TRANSIT GROUP LLC
Role Respondent
Status Active
Name ERIC BRUN
Role Respondent
Status Active
Name SOVEREIGN HEALTHCARE HOLDINGS, LLC
Role Respondent
Status Active
Name Robert Callander
Role Respondent
Status Active
Name Okaloosa County Coordinated Transporation, Inc.
Role Respondent
Status Active
Name FORT WALTON REHABILITATION CENTER, LLC
Role Respondent
Status Active
Representations Thomas A. Valdez, Kimberly J. Lopater, Vilma Martinez
Name John O'Donnell Mangine
Role Respondent
Status Active
Name MARUTI FLEET & MGMT, LLC
Role Respondent
Status Active
Name SOUTHERN HEALTHCARE MANAGEMENT, LLC
Role Respondent
Status Active
Name Hon. Michael Alan Flowers
Role Judge/Judicial Officer
Status Active
Name Hon. J. D. Peacock
Role Lower Tribunal Clerk
Status Active
Name Hon. Kristina Samuels
Role Lower Tribunal Clerk
Status Active

Docket Entries

Docket Date 2022-11-04
Type Disposition
Subtype Rev DY Lack Juris
Description DISP-REV DY LACK JURIS ~ This cause having heretofore been submitted to the Court on jurisdictional briefs and portions of the record deemed necessary to reflect jurisdiction under Article V, Section 3(b), Florida Constitution, and the Court having determined that it should decline to accept jurisdiction, it is ordered that the petition for review is denied.No motion for rehearing will be entertained by the Court. See Fla. R. App. P. 9.330(d)(2).
View View File
Docket Date 2022-11-03
Type Event
Subtype Fee Paid Through Portal
Description Fee Paid Through Portal
Docket Date 2022-11-03
Type Miscellaneous Document
Subtype Pay Case Filing Fee-300
Description PAY CASE FILING FEE-300
On Behalf Of Estate of Etheleene Galloway Gordon
View View File
Docket Date 2022-10-21
Type Miscellaneous Document
Subtype Lower Tribunal Transmittal Cover Sheet (Amended)
Description LOWER TRIBUNAL TRANSMITTAL COVER SHEET AMD ~ To reflect fee status
On Behalf Of Hon. Kristina Samuels
View View File
Docket Date 2022-10-21
Type Order
Subtype Filing Fee Due
Description ORDER-FILING FEE DUE ~ The jurisdiction of this Court was invoked by the filing of a Notice to Invoke Discretionary Jurisdiction in the lower tribunal; however, said notice was not accompanied by the $300.00 filing fee or an order of insolvency from the district court of appeal as required by Florida Rules of Appellate Procedure 9.110(b) and 9.120(b). The filing fee is due and payable at the time of filing the notice. Petitioner is allowed to and including November 21, 2022, in which to submit the filing fee, or an order of insolvency, or a proper motion for leave to proceed in forma pauperis that complies with sections 57.081 and 57.082, Florida Statutes. Failure to submit the filing fee or one of the above referenced documents to this Court could result in the imposition of sanctions, including dismissal of the notice.Please understand that once this case is dismissed, it is not subject to reinstatement.
View View File
Docket Date 2022-09-08
Type Brief
Subtype Juris Answer
Description JURIS ANSWER BRIEF ~ Respondents' Jurisdictional Answer Brief
On Behalf Of Fort Walton Rehabilitation Center, LLC
View View File
Docket Date 2022-08-30
Type Order
Subtype Extension of Time (Juris Brief)
Description ORDER-EXT OF TIME GR (JURIS BRIEF-RESPONDENT) ~ Respondent's motion for extension of time is granted and respondent is allowed to and including September 8, 2022, in which to serve the jurisdictional answer brief. Multiple extensions of time for the same filing are discouraged. Absent extenuating circumstances, subsequent requests may be denied.
View View File
Docket Date 2022-08-29
Type Motion
Subtype Ext of Time (Juris Brief)
Description MOTION-EXT OF TIME (JURIS BRIEF) ~ Unopposed Motion for Extension of Time to File Respondents' Jurisdictional Answer Brief
On Behalf Of Fort Walton Rehabilitation Center, LLC
View View File
Docket Date 2022-07-29
Type Brief
Subtype Appendix-Juris
Description APPENDIX-JURIS BRIEF ~ Petitioner's Appendix
On Behalf Of Estate of Etheleene Galloway Gordon
View View File
Docket Date 2022-07-26
Type Letter-Case
Subtype Acknowledgment Letter-New Case
Description ACKNOWLEDGMENT LETTER-NEW CASE
View View File
Docket Date 2022-07-25
Type Misc. Events
Subtype Fee Status
Description FP:Fee Paid Through Portal
Docket Date 2022-07-25
Type Notice
Subtype Invoke Discretionary Jurisdiction
Description NOTICE-DISCRETIONARY JURIS (DIRECT CONFLICT)
On Behalf Of Estate of Etheleene Galloway Gordon
View View File

Documents

Name Date
ANNUAL REPORT 2024-02-05
ANNUAL REPORT 2023-03-09
ANNUAL REPORT 2022-02-24
ANNUAL REPORT 2021-03-18
ANNUAL REPORT 2020-04-14
ANNUAL REPORT 2019-03-21
ANNUAL REPORT 2018-04-27
ANNUAL REPORT 2017-03-30
ANNUAL REPORT 2016-03-23
ANNUAL REPORT 2015-01-13

Date of last update: 24 Jan 2025

Sources: Florida Department of State