| Entity Name: | SRB ASSIST, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 04 Mar 2003 (22 years ago) |
| Date of dissolution: | 23 Sep 2016 (8 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2016 (8 years ago) |
| Document Number: | P03000025746 |
| FEI/EIN Number | 550820644 |
| Address: | 242 WINTER NELLIS CIR, WINTER GARDEN, FL, 34787, US |
| Mail Address: | 242 WINTER NELLIS CIR, WINTER GARDEN, FL, 34787, US |
| ZIP code: | 34787 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1922147800 | 2007-02-06 | 2015-07-09 | 242 WINTER NELLIS CIR, WINTER GARDEN, FL, 34787, US | 242 WINTER NELLIS CIR, WINTER GARDEN, FL, 34787, US | |||||||||||||||||||||||||
|
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| Phone | +1 407-395-9344 |
| Fax | 4073959346 |
Authorized person
| Name | MS. SUZANNE RAVITA BLACKBURN |
| Role | PRESIDENT |
| Phone | 4974450215 |
Taxonomy
| Taxonomy Code | 163W00000X - Registered Nurse |
| License Number | RN3314902 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 310681100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BLACKBURN SUZANNE R | Agent | 242 WINTER NELLIS CIR, WINTER GARDEN, FL, 34787 |
| Name | Role | Address |
|---|---|---|
| BLACKBURN SUZANNE R | President | 242 WINTER NELLIS CIR, WINTER GARDEN, FL, 34787 |
| Name | Role | Address |
|---|---|---|
| BLACKBURN SUZANNE R | Secretary | 242 WINTER NELLIS CIR, WINTER GARDEN, FL, 34787 |
| Name | Role | Address |
|---|---|---|
| BLACKBURN SUZANNE R | Treasurer | 242 WINTER NELLIS CIR, WINTER GARDEN, FL, 34787 |
| Name | Role | Address |
|---|---|---|
| BLACKBURN SUZANNE R | Vice President | 242 WINTER NELLIS CIR, WINTER GARDEN, FL, 34787 |
| Name | Role | Address |
|---|---|---|
| BLACKBURN SUZANNE R | Director | 242 WINTER NELLIS CIR, WINTER GARDEN, FL, 34787 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-04-22 | 242 WINTER NELLIS CIR, WINTER GARDEN, FL 34787 | No data |
| CHANGE OF MAILING ADDRESS | 2015-04-22 | 242 WINTER NELLIS CIR, WINTER GARDEN, FL 34787 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-04-22 | 242 WINTER NELLIS CIR, WINTER GARDEN, FL 34787 | No data |
| REGISTERED AGENT NAME CHANGED | 2010-04-06 | BLACKBURN, SUZANNE R | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2015-04-22 |
| ANNUAL REPORT | 2014-04-07 |
| ANNUAL REPORT | 2013-04-15 |
| ANNUAL REPORT | 2012-03-28 |
| ANNUAL REPORT | 2011-04-11 |
| ANNUAL REPORT | 2010-04-06 |
| ANNUAL REPORT | 2009-04-15 |
| ANNUAL REPORT | 2008-04-14 |
| ANNUAL REPORT | 2007-04-05 |
| Reg. Agent Change | 2007-03-12 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
