| Entity Name: | PREMIER REHAB, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
PREMIER REHAB, INC. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 09 Dec 1993 (31 years ago) |
| Document Number: | P93000084125 |
| FEI/EIN Number |
593214567
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 911 N. SPRING GARDEN AVE, DELAND, FL, 32720, US |
| Mail Address: | 911 N. SPRING GARDEN AVE, DELAND, FL, 32720, US |
| ZIP code: | 32720 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1467490136 | 2006-06-03 | 2022-09-15 | 911 N SPRING GARDEN AVE, DELAND, FL, 327202560, US | 911 N SPRING GARDEN AVE, DELAND, FL, 32720, US | |||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 386-736-3108 |
| Fax | 3867363643 |
Authorized person
| Name | BARBARA ANNETTE DIVINCENZO |
| Role | ADMINISTRATOR/ CEO |
| Phone | 3867363108 |
Taxonomy
| Taxonomy Code | 225X00000X - Occupational Therapist |
| License Number | 2674 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 235Z00000X - Speech-Language Pathologist |
| Is Primary | No |
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QR0400X - Rehabilitation Clinic/Center |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 882094500 |
| State | FL |
| Issuer | MEDICAID |
| Number | 681664996 |
| State | FL |
| Issuer | BLUE CROSS & BLUE SHIELD |
| Number | R5L |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PREMIER REHAB INC 401K | 2023 | 593214567 | 2024-09-02 | PREMIER REHAB INC | 1 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-09-02 |
| Name of individual signing | NICK RICE |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| DIVINCENZO BARBARA A | Director | 911 N. SPRING GARDEN AVE, DELAND, FL, 32720 |
| DIVINCENZO BARBARA A | Agent | 1023 MARJORIE RAWLINGS DRIVE, DELAND, FL, 32720 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000063199 | FYZICAL OF DAYTONA | ACTIVE | 2018-05-29 | 2028-12-31 | - | 911 N SPRING GARDEN AVE, DELAND, FL, 32720 |
| G18000040809 | FYZICAL OF DELAND | ACTIVE | 2018-03-28 | 2028-12-31 | - | 911 N SPRING GARDEN AVE, DELAND, FL, 32720 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2003-04-09 | 911 N. SPRING GARDEN AVE, DELAND, FL 32720 | - |
| CHANGE OF MAILING ADDRESS | 2003-04-09 | 911 N. SPRING GARDEN AVE, DELAND, FL 32720 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2003-04-09 | 1023 MARJORIE RAWLINGS DRIVE, DELAND, FL 32720 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-07 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-02-01 |
| ANNUAL REPORT | 2021-01-28 |
| ANNUAL REPORT | 2020-02-26 |
| ANNUAL REPORT | 2019-01-29 |
| ANNUAL REPORT | 2018-01-14 |
| ANNUAL REPORT | 2017-02-26 |
| ANNUAL REPORT | 2016-01-24 |
| ANNUAL REPORT | 2015-01-29 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 5447258506 | 2021-02-27 | 0491 | PPS | 911 N Spring Garden Ave, Deland, FL, 32720-2560 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 5885267306 | 2020-04-30 | 0491 | PPP | 911 N SPRING GARDEN AVE, DELAND, FL, 32720-2560 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Apr 2025
Sources: Florida Department of State
