| Entity Name: | GENOMA MEDICAL & REHABILITATION CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 23 Aug 2011 (13 years ago) |
| Date of dissolution: | 25 Sep 2015 (9 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2015 (9 years ago) |
| Document Number: | P11000074828 |
| FEI/EIN Number | 453060195 |
| Address: | 3389 LAGO DE TALAVERA, Lake Worth, FL, 33467, US |
| Mail Address: | 3389 LAGO DE TALAVERA, Lake Worth, FL, 33467, US |
| ZIP code: | 33467 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1760763692 | 2011-09-06 | 2011-09-06 | 6555 NW 36TH ST STE 116117, VIRGINIA GARDENS, FL, 331666978, US | 6555 NW 36TH ST STE 116117, VIRGINIA GARDENS, FL, 331666978, US | |||||||||||||||||||
|
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| Phone | +1 305-874-2229 |
| Fax | 3058742229 |
Authorized person
| Name | MR. RAYDEL MIRANDA |
| Role | PRESIDENT/MASSAGE THERAPIST |
| Phone | 3058345695 |
Taxonomy
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| License Number | MA 63085 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Fuster Dionys Y | Agent | 3389 LAGO DE TALAVERA, Lake Worth, FL, 33467 |
| Name | Role | Address |
|---|---|---|
| Fuster Dionys Y | President | 3389 LAGO DE TALAVERA, Lake Worth, FL, 33467 |
| Name | Role | Address |
|---|---|---|
| Miranda Raydel | Vice President | 3389 LAGO DE TALAVERA, Lake Worth, FL, 33467 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2014-04-01 | 3389 LAGO DE TALAVERA, Lake Worth, FL 33467 | No data |
| CHANGE OF MAILING ADDRESS | 2014-04-01 | 3389 LAGO DE TALAVERA, Lake Worth, FL 33467 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-04-01 | 3389 LAGO DE TALAVERA, Lake Worth, FL 33467 | No data |
| REGISTERED AGENT NAME CHANGED | 2013-04-05 | Fuster, Dionys Y. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2014-04-01 |
| ANNUAL REPORT | 2013-04-05 |
| ANNUAL REPORT | 2012-01-24 |
| Domestic Profit | 2011-08-23 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
