| Entity Name: | PARTNERS IN HEALTH F.O.R.M.E. MEDICAL AND REHAB CENTERS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
PARTNERS IN HEALTH F.O.R.M.E. MEDICAL AND REHAB CENTERS, INC. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| 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: | 03 Dec 2002 (22 years ago) |
| Date of dissolution: | 30 Apr 2017 (8 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 30 Apr 2017 (8 years ago) |
| Document Number: | P02000127288 |
| FEI/EIN Number |
593773826
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Mail Address: | PO Box 171742, Miami, FL, 33017, US |
| Address: | 9730 NW 2 AVE, MIAMI SHORES, FL, 33138 |
| ZIP code: | 33138 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1558495259 | 2007-03-15 | 2013-08-21 | 9730 NE 2ND AVE, MIAMI SHORES, FL, 331382311, US | 9730 NE 2ND AVE, MIAMI SHORES, FL, 331382311, US | |||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 305-758-7979 |
| Fax | 3057580034 |
Authorized person
| Name | MR. HENRY ROBERT SANON |
| Role | CEO/PHYSICIAN |
| Phone | 3057587979 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH7398 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH9614 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 208000000X - Pediatrics Physician |
| License Number | ME26113 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 258983400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SANON HENRY R | President | 9730 NE 2 AVE, MIAMI SHORES, FL, 33138 |
| SANON HENRY R | Agent | 9730 NE 2 AVE, MAIMI SHORES, FL, 33138 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2017-04-30 | - | - |
| CHANGE OF MAILING ADDRESS | 2016-04-28 | 9730 NW 2 AVE, MIAMI SHORES, FL 33138 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2012-04-30 | 9730 NE 2 AVE, MAIMI SHORES, FL 33138 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2012-04-30 | 9730 NW 2 AVE, MIAMI SHORES, FL 33138 | - |
| CANCEL ADM DISS/REV | 2007-01-05 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2006-09-15 | - | - |
| CANCEL ADM DISS/REV | 2005-05-02 | - | - |
| REGISTERED AGENT NAME CHANGED | 2005-05-02 | SANON, HENRY RDR. | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2004-10-01 | - | - |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J14000054188 | TERMINATED | 1000000569582 | MIAMI-DADE | 2014-01-02 | 2034-01-09 | $ 330.00 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, MIAMI SERVICE CENTER, 8175 NW 12TH ST STE 119, DORAL FL331261828 |
| J13001783316 | TERMINATED | 1000000552482 | MIAMI-DADE | 2013-11-07 | 2023-12-26 | $ 953.71 | STATE OF FLORIDA0060265 |
| J13001437715 | TERMINATED | 1000000468121 | MIAMI-DADE | 2013-09-12 | 2033-10-03 | $ 330.00 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, MIAMI SERVICE CENTER, 8175 NW 12TH ST STE 119, DORAL FL331261828 |
| J12000187107 | TERMINATED | 1000000256083 | DADE | 2012-03-05 | 2032-03-14 | $ 660.00 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, MIAMI NORTH SERVICE CENTER, 8175 NW 12TH ST STE 119, DORAL FL331261828 |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2017-04-30 |
| ANNUAL REPORT | 2016-04-28 |
| ANNUAL REPORT | 2015-05-01 |
| ANNUAL REPORT | 2014-04-30 |
| ANNUAL REPORT | 2013-04-29 |
| ANNUAL REPORT | 2012-04-30 |
| ANNUAL REPORT | 2011-04-29 |
| ANNUAL REPORT | 2010-05-03 |
| ANNUAL REPORT | 2009-04-08 |
| ANNUAL REPORT | 2008-04-30 |
Date of last update: 03 Apr 2025
Sources: Florida Department of State
