| Entity Name: | PALM BEACH REHABILITATION CLINIC, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 12 Sep 2014 (10 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: | P14000075744 |
| Address: | 6586 HYPOLUXO RD, SUITE # 306, LAKE WORTH, FL, 33467 |
| Mail Address: | 6586 HYPOLUXO RD, SUITE # 306, LAKE WORTH, FL, 33467 |
| ZIP code: | 33467 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1952705568 | 2014-10-13 | 2014-10-27 | 6586 HYPOLUXO RD, STE 306, LAKE WORTH, FL, 334677678, US | 6586 HYPOLUXO RD, STE 306, LAKE WORTH, FL, 334677678, US | |||||||||||||||||||
|
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| Phone | +1 561-386-3485 |
| Fax | 3055042737 |
Authorized person
| Name | DR. NESTOR FERNANDEZ |
| Role | MEDICAL DIRECTOR |
| Phone | 5613863485 |
Taxonomy
| Taxonomy Code | 261QH0100X - Health Service Clinic/Center |
| License Number | ME56218 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| ALFONSO JUSTO R | Agent | 6586 HYPOLUXO RD, LAKE WORTH, FL, 33467 |
| Name | Role | Address |
|---|---|---|
| ALFONSO JUSTO R | President | 6586 HYPOLUXO RD, SUITE # 306, LAKE WORTH, FL, 33467 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| Name | Date |
|---|---|
| Domestic Profit | 2014-09-12 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
