| Entity Name: | GULF COAST REHABILITATION SERVICES, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 05 Dec 2003 (21 years ago) |
| Document Number: | P03000147034 |
| FEI/EIN Number | 450491431 |
| Address: | 4905 34th Street S, Unit 363, St Petersburg, FL, 33711, US |
| Mail Address: | 4905 34th Street S, Unit 363, St Petersburg, FL, 33711, US |
| ZIP code: | 33711 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1447569264 | 2010-09-28 | 2014-03-19 | PO BOX 13798, TAMPA, FL, 336813798, US | 3825 HENDERSON BLVD, SUITE 405, TAMPA, FL, 336295037, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 877-957-3422 |
| Fax | 8779573422 |
Authorized person
| Name | DR. JOSHUA ELLIOTT SHANNON |
| Role | CEO |
| Phone | 8779573422 |
Taxonomy
| Taxonomy Code | 101Y00000X - Counselor |
| License Number | MH11189 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 101YA0400X - Addiction (Substance Use Disorder) Counselor |
| License Number | 5525 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 101YA0400X - Addiction (Substance Use Disorder) Counselor |
| License Number | 5552 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | MH11189 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 101YP2500X - Professional Counselor |
| License Number | SW7468 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 101YP2500X - Professional Counselor |
| License Number | MH11189 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 102L00000X - Psychoanalyst |
| License Number | SW7468 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 102L00000X - Psychoanalyst |
| License Number | MH11189 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 103K00000X - Behavior Analyst |
| License Number | SW7468 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 104100000X - Social Worker |
| License Number | SW7468 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| License Number | SW7468 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| SHANNON JOSHUA E | Agent | 4905 34th Street S, St Petersburg, FL, 33711 |
| Name | Role | Address |
|---|---|---|
| SHANNON JOSHUA E | Chief Executive Officer | 4905 34th Street S, St Petersburg, FL, 33711 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G09000148850 | GULF ATLANTIC PARTNERS | EXPIRED | 2009-08-24 | 2014-12-31 | No data | 12735 KINGS LAKE DRIVE, GIBSONTON, FL, 33534 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-02-26 | 4905 34th Street S, Unit 363, St Petersburg, FL 33711 | No data |
| CHANGE OF MAILING ADDRESS | 2024-02-26 | 4905 34th Street S, Unit 363, St Petersburg, FL 33711 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-26 | 4905 34th Street S, Unit 363, St Petersburg, FL 33711 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-26 |
| ANNUAL REPORT | 2023-03-23 |
| ANNUAL REPORT | 2022-02-28 |
| ANNUAL REPORT | 2021-02-03 |
| ANNUAL REPORT | 2020-01-27 |
| ANNUAL REPORT | 2019-04-22 |
| ANNUAL REPORT | 2018-03-10 |
| ANNUAL REPORT | 2017-01-05 |
| ANNUAL REPORT | 2016-07-08 |
| ANNUAL REPORT | 2015-03-15 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
