| Entity Name: | CENTRO DE REHABILITACION NUEVA VIDA CORP |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 20 Mar 2017 (8 years ago) |
| Document Number: | P17000025983 |
| FEI/EIN Number | 820920741 |
| Address: | 1840 WEST 49 STREET, HIALEAH, FL, 33012, US |
| Mail Address: | 1840 WEST 49 STREET, HIALEAH, FL, 33012, US |
| ZIP code: | 33012 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1194239368 | 2017-11-27 | 2023-10-30 | 1840 W 49TH ST STE 605, HIALEAH, FL, 330122962, US | 1840 W 49TH ST STE 605, HIALEAH, FL, 330122962, US | |||||||||||||||||||||||||||||||
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| Phone | +1 786-294-0453 |
| Fax | 7862940243 |
Authorized person
| Name | BARBARITA GARCIA |
| Role | PRESIDENT |
| Phone | 7862940453 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | Yes |
| Taxonomy Code | 261QR0400X - Rehabilitation Clinic/Center |
| Is Primary | No |
Other Provider Identifiers
| Issuer | HCC 11078 |
| Number | AHCA |
| State | FL |
| Issuer | MEDICAID |
| Number | 107841200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GARCIA BARBARITA | Agent | 1840 WEST 49 STREET, HIALEAH, FL, 33012 |
| Name | Role | Address |
|---|---|---|
| GARCIA BARBARITA | President | 1840 WEST 49 STREET, HIALEAH, FL, 33012 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-03-17 | 1840 WEST 49 STREET, SUITE 605, HIALEAH, FL 33012 | No data |
| CHANGE OF MAILING ADDRESS | 2022-03-17 | 1840 WEST 49 STREET, SUITE 605, HIALEAH, FL 33012 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-03-17 | 1840 WEST 49 STREET, SUITE 605, HIALEAH, FL 33012 | No data |
| REGISTERED AGENT NAME CHANGED | 2020-08-13 | GARCIA, BARBARITA | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-07 |
| ANNUAL REPORT | 2023-02-07 |
| ANNUAL REPORT | 2022-03-17 |
| AMENDED ANNUAL REPORT | 2021-08-04 |
| ANNUAL REPORT | 2021-04-07 |
| AMENDED ANNUAL REPORT | 2020-09-06 |
| AMENDED ANNUAL REPORT | 2020-08-13 |
| AMENDED ANNUAL REPORT | 2020-07-27 |
| AMENDED ANNUAL REPORT | 2020-01-20 |
| ANNUAL REPORT | 2020-01-18 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
