| Entity Name: | PAIN RELIEF AND PHYSICAL REHAB, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
PAIN RELIEF AND PHYSICAL REHAB, 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: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 26 Aug 2008 (17 years ago) |
| Document Number: | P08000079339 |
| FEI/EIN Number |
263254428
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 4977 ROYAL GULF CIR., FORT MYERS, FL, 33966, US |
| Mail Address: | P. O. BOX 222, ESTERO, FL, 33929, US |
| ZIP code: | 33966 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1134378938 | 2008-09-17 | 2023-09-26 | 9705 COMMERCE CENTER CT STE 103, FORT MYERS, FL, 339083767, US | 4977 ROYAL GULF CIR, FORT MYERS, FL, 339667006, US | |||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 239-437-9313 |
| Fax | 2392458060 |
| Phone | +1 239-226-0077 |
| Fax | 2394890077 |
Authorized person
| Name | DR. KEITH S SUSKO |
| Role | PRESIDENT |
| Phone | 2392260077 |
Taxonomy
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| Is Primary | Yes |
| Taxonomy Code | 208VP0000X - Pain Medicine Physician |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 17033 |
| State | FL |
| Issuer | MEDICAID |
| Number | 2658666-00 |
| State | FL |
| Issuer | MEDICARE |
| Number | 17033X |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SUSKO KEITH | President | P. O. BOX 222, ESTERO, FL, 33929 |
| SUSKO KEITH | Secretary | P. O. BOX 222, ESTERO, FL, 33929 |
| SUSKO KEITH | Treasurer | P. O. BOX 222, ESTERO, FL, 33929 |
| SUSKO KEITH | Director | P. O. BOX 222, ESTERO, FL, 33929 |
| JENNER TARA R | Vice President | P. O. BOX 222, ESTERO, FL, 33929 |
| JENNER TARA R | Director | P. O. BOX 222, ESTERO, FL, 33929 |
| SUSKO KEITH | Agent | 4977 ROYAL GULF CIR., FORT MYERS, FL, 33966 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000029601 | IDEAL WEIGHT AND WELLNESS | EXPIRED | 2019-03-04 | 2024-12-31 | - | P.O. BOX 222, ESTERO, FL, 33929 |
| G08329900037 | IDEAL WEIGHT AND WELLNESS | EXPIRED | 2008-11-19 | 2013-12-31 | - | 12734 KENWOOD LN, #96, FORT MYERS, FL, 33907 |
| G08241900361 | PAIN RELIEF AND PHYSICAL REHAB | EXPIRED | 2008-08-28 | 2013-12-31 | - | 12734 KENWOOD LN, #96, FORT MYERS, FL, 33907 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2019-04-19 | 4977 ROYAL GULF CIR., FORT MYERS, FL 33966 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2018-07-31 | 4977 ROYAL GULF CIR., FORT MYERS, FL 33966 | - |
| CHANGE OF MAILING ADDRESS | 2010-04-22 | 4977 ROYAL GULF CIR., FORT MYERS, FL 33966 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-04-12 |
| ANNUAL REPORT | 2022-08-14 |
| ANNUAL REPORT | 2021-09-22 |
| ANNUAL REPORT | 2020-05-25 |
| ANNUAL REPORT | 2019-04-19 |
| ANNUAL REPORT | 2018-04-25 |
| ANNUAL REPORT | 2017-04-28 |
| ANNUAL REPORT | 2016-04-01 |
| ANNUAL REPORT | 2015-04-28 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1220097801 | 2020-05-01 | 0455 | PPP | 4977 ROYAL GULF CIR, FORT MYERS, FL, 33966 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 5747108509 | 2021-03-01 | 0455 | PPS | 4977 Royal Gulf Cir, Fort Myers, FL, 33966-7006 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 03 Apr 2025
Sources: Florida Department of State
