| Entity Name: | VISTA THERAPY SERVICES, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 20 Dec 2005 (19 years ago) |
| Date of dissolution: | 24 Sep 2021 (3 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2021 (3 years ago) |
| Document Number: | P05000165195 |
| FEI/EIN Number | 203990814 |
| Address: | 3221 NE 16th ST, Pompano Beach, FL, 33062, US |
| Mail Address: | 3221 NE 16th ST, Pompano Beach, FL, 33062, US |
| ZIP code: | 33062 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114253382 | 2009-10-23 | 2009-10-23 | 6634 79 AVE., PINELLAS PARK, FL, 33781, US | 6634 79 AVE., PINELLAS PARK, FL, 33781, US | |||||||||||||||||||||||
|
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| Phone | +1 727-504-6941 |
Authorized person
| Name | DARREN L BENNETT |
| Role | PRESIDENT |
| Phone | 7275046941 |
Taxonomy
| Taxonomy Code | 235Z00000X - Speech-Language Pathologist |
| License Number | SA6805 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 8887454 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BENETT DARREN L | Agent | 3221 NE 16th ST, Pompano Beach, FL, 33062 |
| Name | Role | Address |
|---|---|---|
| BENNETT DARREN L | Director | 3221 NE 16th ST, Pompano Beach, FL, 33062 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-03-29 | 3221 NE 16th ST, 104, Pompano Beach, FL 33062 | No data |
| CHANGE OF MAILING ADDRESS | 2020-03-29 | 3221 NE 16th ST, 104, Pompano Beach, FL 33062 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-04-04 | 3221 NE 16th ST, 104, Pompano Beach, FL 33062 | No data |
| REINSTATEMENT | 2012-10-24 | No data | No data |
| PENDING REINSTATEMENT | 2012-10-24 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| NAME CHANGE AMENDMENT | 2008-09-05 | VISTA THERAPY SERVICES, PA | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2020-03-29 |
| ANNUAL REPORT | 2019-04-04 |
| ANNUAL REPORT | 2018-04-09 |
| ANNUAL REPORT | 2017-04-10 |
| ANNUAL REPORT | 2016-03-11 |
| ANNUAL REPORT | 2015-04-08 |
| ANNUAL REPORT | 2014-04-10 |
| ANNUAL REPORT | 2013-02-01 |
| REINSTATEMENT | 2012-10-24 |
| ANNUAL REPORT | 2010-02-21 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
