| Entity Name: | MEDICAL & REHAB OF HILLSBOROUGH INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 14 Jun 2013 (12 years ago) |
| Last Event: | NAME CHANGE AMENDMENT |
| Event Date Filed: | 19 May 2016 (9 years ago) |
| Document Number: | P13000051608 |
| FEI/EIN Number | 46-2974387 |
| Mail Address: | PO BOX 151686, TAMPA, FL, 33684, US |
| Address: | 2916 W Waters ave., TAMPA, FL, 33614, US |
| ZIP code: | 33614 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1760937981 | 2016-08-17 | 2024-03-20 | PO BOX 151686, TAMPA, FL, 336841686, US | 2916 W WATERS AVE, TAMPA, FL, 336141869, US | |||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||
| Phone | +1 813-443-8221 |
| Fax | 8134431869 |
Authorized person
| Name | PEDRO M HERNANDEZ |
| Role | OWNER |
| Phone | 8134438221 |
Taxonomy
| Taxonomy Code | 103K00000X - Behavior Analyst |
| Is Primary | Yes |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| License Number | HCC10384 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | No |
Other Provider Identifiers
| Issuer | AGENCY FOR HEALTH CARE ADMINISTRATION |
| Number | HCC10384 |
| State | FL |
| Issuer | MEDICAID |
| Number | 109961000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HERNANDEZ PEDRO M | Agent | 2916 W Waters ave., Tampa, FL, 33614 |
| Name | Role | Address |
|---|---|---|
| HERNANDEZ PEDRO M | President | 2619 W WATERS AVE, TAMPA, FL, 33614 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000088807 | MEDICAL & REHAB OF HILLSBOROUGH INC. | EXPIRED | 2019-08-21 | 2024-12-31 | No data | P.O. BOX 270813, TAMPA, FL, 33688 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2021-02-04 | 2916 W Waters ave., STE A2, SUITE 100, Tampa, FL 33614 | No data |
| CHANGE OF MAILING ADDRESS | 2020-12-22 | 2916 W Waters ave., TAMPA, FL 33614 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-09-14 | 2916 W Waters ave., TAMPA, FL 33614 | No data |
| NAME CHANGE AMENDMENT | 2016-05-19 | MEDICAL & REHAB OF HILLSBOROUGH INC. | No data |
| REGISTERED AGENT NAME CHANGED | 2016-05-12 | HERNANDEZ, PEDRO M | No data |
| AMENDMENT | 2016-04-28 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-07-15 |
| ANNUAL REPORT | 2023-01-30 |
| ANNUAL REPORT | 2022-04-26 |
| ANNUAL REPORT | 2021-02-04 |
| ANNUAL REPORT | 2020-01-20 |
| ANNUAL REPORT | 2019-02-04 |
| ANNUAL REPORT | 2018-02-20 |
| ANNUAL REPORT | 2017-02-07 |
| AMENDED ANNUAL REPORT | 2016-07-14 |
| Name Change | 2016-05-19 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
