| Entity Name: | PENINSULA REHABILITATION AND NURSING CENTER LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 07 Jul 2022 (3 years ago) |
| Date of dissolution: | 27 Sep 2024 (4 months ago) |
| Last Event: | REVOKED FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2024 (4 months ago) |
| Document Number: | M22000010482 |
| FEI/EIN Number | 88-3151563 |
| Address: | 900 BECKETT WAY, TARPON SPRINGS, FL 34689 |
| Mail Address: | 900 BECKETT WAY, TARPON SPRINGS, FL 34689 |
| ZIP code: | 34689 |
| County: | Pinellas |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1801521141 | 2022-07-20 | 2022-07-20 | 900 BECKETT WAY, TARPON SPRINGS, FL, 346895709, US | 900 BECKETT WAY, TARPON SPRINGS, FL, 346895709, US | |||||||||||||||||||||
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| Phone | +1 727-934-0876 |
| Fax | 7275458783 |
Authorized person
| Name | MATHEW VARGHESE |
| Role | MEMBER |
| Phone | 9178173530 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | LICENSE |
| Number | 1082095 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Klein, Yoel | Agent | 115 NORTH CALHOUN ST., SUITE 4, TALLAHASSEE, FL 32301 |
| Name | Role | Address |
|---|---|---|
| SCHLANGER, ALAN | Authorized Person | 6085 STRICKLAND AVENUE, BROOKLYN, NY 11234 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000095974 | PENINSULA REHABILTATION AND NURSING CENTER | ACTIVE | 2022-08-15 | 2027-12-31 | No data | 900 BECKETT WAY, TARPON SPRINGS, FL, 34689 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REVOKED FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| REINSTATEMENT | 2023-10-18 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2023-10-18 | Klein, Yoel | No data |
| REVOKED FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2023-10-18 |
| Foreign Limited | 2022-07-07 |
Date of last update: 12 Jan 2025
Sources: Florida Department of State
