| Entity Name: | 360 REHAB SERVICES INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 16 Mar 2015 (10 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 09 Apr 2017 (8 years ago) |
| Document Number: | P15000024782 |
| FEI/EIN Number | 47-3443881 |
| Address: | 12161 Taft Street, Pembroke Pines, FL 33026 |
| Mail Address: | 12161 Taft Street, pembroke pines, FL 33026 |
| ZIP code: | 33026 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538727516 | 2019-06-04 | 2019-08-19 | 12251 TAFT ST, PEMBROKE PINES, FL, 330261901, US | 12251 TAFT ST, PEMBROKE PINES, FL, 330261901, US | |||||||||||||||||||
|
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| Phone | +1 954-648-5565 |
Authorized person
| Name | DR. DAINIELLE GORDON-CORNWALL |
| Role | PRESIDENT/OWNER |
| Phone | 9546485565 |
Taxonomy
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PT LICENSE |
| Number | PT25081 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GORDON-CORNWALL, DAINIELLE P | Agent | 1931 SW 148TH WAY, MIRAMAR, FL 33027 |
| Name | Role | Address |
|---|---|---|
| GORDON-CORNWALL, DAINIELLE P | President | 12161 TAFT ST, PEMBROKE PINES, FL 33026 |
| Name | Role | Address |
|---|---|---|
| Cornwall, Jordan Wayne | Trustee | 1931 SW 148TH WAY, MIRAMAR, FL 33023 |
| Cornwall, Kailyn Addison | Trustee | 1931 SW 148th Way, Miramar, FL 33027 |
| Name | Role | Address |
|---|---|---|
| Cornwall, Kailyn Addison | Co | 1931 SW 148th Way, Miramar, FL 33027 |
| Name | Role | Address |
|---|---|---|
| Gordon, Darrell Dean | Executive Secretary | 1052 SW 113th, Pembroke Pines, FL 33025 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-01-24 | 12161 Taft Street, Pembroke Pines, FL 33026 | No data |
| CHANGE OF MAILING ADDRESS | 2020-04-09 | 12161 Taft Street, Pembroke Pines, FL 33026 | No data |
| REINSTATEMENT | 2017-04-09 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2017-04-09 | GORDON-CORNWALL, DAINIELLE P | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-07-09 |
| ANNUAL REPORT | 2024-01-24 |
| ANNUAL REPORT | 2023-05-01 |
| ANNUAL REPORT | 2022-04-26 |
| ANNUAL REPORT | 2021-04-22 |
| ANNUAL REPORT | 2020-04-10 |
| ANNUAL REPORT | 2019-03-19 |
| ANNUAL REPORT | 2018-04-17 |
| REINSTATEMENT | 2017-04-09 |
| Domestic Profit | 2015-03-16 |
Date of last update: 20 Feb 2025
Sources: Florida Department of State
