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  5. VICTORIA NURSING & REHABILITATION CENTER, INC.

VICTORIA NURSING & REHABILITATION CENTER, INC. - Florida Company Profile

Company Details

Entity Name: VICTORIA NURSING & REHABILITATION CENTER, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit

VICTORIA NURSING & REHABILITATION CENTER, 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: 15 Jul 1997 (28 years ago)
Last Event: AMENDMENT
Event Date Filed: 22 Aug 2011 (14 years ago)
Document Number: P97000061646
FEI/EIN Number 311558831

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 955 NW 3RD ST, MIAMI, FL, 33128
Mail Address: 955 NW 3RD ST, MIAMI, FL, 33128
ZIP code: 33128
County: Miami-Dade
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1447249149 2005-10-17 2024-09-04 955 NW 3RD ST, MIAMI, FL, 331281274, US 955 NW 3RD ST, MIAMI, FL, 331281274, US

Contacts
Phone +1 305-548-4020
Fax 3055485018
Fax 3057772000

Authorized person
Name RICHARD STACEY
Role VICE PRESIDENT
Phone 3055484020

Taxonomy
Taxonomy Code 314000000X - Skilled Nursing Facility
License Number SNF130471016
State FL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 022517700
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
VICTORIA NURSING & REHABILITATION CENTER 2015 311558831 2016-10-13 VICTORIA NURSING & REHABILITATION CENTER 155
File View Page
Three-digit plan number (PN) 510
Effective date of plan 2013-05-01
Business code 623000
Sponsor’s telephone number 3055484020
Plan sponsor’s mailing address 955 NW 3RD ST, MIAMI, FL, 331281274
Plan sponsor’s address 955 NW 3RD ST, MIAMI, FL, 331281274

Number of participants as of the end of the plan year
Active participants 152
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2016-10-12
Name of individual signing RALPH STACEY
Valid signature Filed with authorized/valid electronic signature
VICTORIA NURSING & REHABILITATION CENTER 2015 311558831 2016-10-02 VICTORIA NURSING & REHABILITATION CENTER 155
Three-digit plan number (PN) 510
Effective date of plan 2013-05-01
Business code 623000
Sponsor’s telephone number 3055484020
Plan sponsor’s mailing address 955 NW 3RD ST, MIAMI, FL, 331281274
Plan sponsor’s address 955 NW 3RD ST, MIAMI, FL, 331281274

Plan administrator’s name and address
Administrator’s EIN 651056686
Plan administrator’s name PEOPLE FIRST, INC.
Plan administrator’s address 1860 N. PINE ISLAND ROAD #106, PLANTATION, FL, 33322
Administrator’s telephone number 9545876100

Number of participants as of the end of the plan year
Active participants 152
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2016-10-02
Name of individual signing BARBARA FLYNN
Valid signature Filed with authorized/valid electronic signature
VICTORIA NURSING & REHABILITATION CENTER 2014 311558831 2015-08-27 VICTORIA NURSING & REHABILITATION CENTER 161
File View Page
Three-digit plan number (PN) 510
Effective date of plan 2013-05-01
Business code 623000
Sponsor’s telephone number 3055484020
Plan sponsor’s mailing address 955 NW 3 STREET, MIAMI, FL, 33128
Plan sponsor’s address 955 NW 3 STREET, MIAMI, FL, 33128

Number of participants as of the end of the plan year
Active participants 155
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2015-08-27
Name of individual signing RALPH STACEY
Valid signature Filed with authorized/valid electronic signature
VICTORIA NURSING & REHABILITATION CENTER 2012 311558831 2013-09-13 VICTORIA NURSING & REHABILITATION CENTER 104
File View Page
Three-digit plan number (PN) 511
Effective date of plan 2005-06-01
Business code 623000
Sponsor’s telephone number 3055484020
Plan sponsor’s mailing address 955 NW 3 STREET, MIAMI, FL, 33128
Plan sponsor’s address 955 NW 3 STREET, MIAMI, FL, 33128

Number of participants as of the end of the plan year
Active participants 107
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2013-09-13
Name of individual signing RALPH STACEY
Valid signature Filed with authorized/valid electronic signature
VICTORIA NURSING & REHABILITATION CENTER 2012 311558831 2013-09-13 VICTORIA NURSING & REHABILITATION CENTER 122
File View Page
Three-digit plan number (PN) 510
Effective date of plan 2009-05-01
Business code 623000
Sponsor’s telephone number 3055484020
Plan sponsor’s mailing address 955 NW 3 STREET, MIAMI, FL, 33128
Plan sponsor’s address 955 NW 3 STREET, MIAMI, FL, 33128

Number of participants as of the end of the plan year
Active participants 139
Retired or separated participants receiving benefits 1
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2013-09-13
Name of individual signing RALPH STACEY
Valid signature Filed with authorized/valid electronic signature
VICTORIA NURSING & REHABILITATION CENTER 2011 311558831 2012-09-26 VICTORIA NURSING & REHABILITATION CENTER 125
File View Page
Three-digit plan number (PN) 510
Effective date of plan 2009-05-01
Business code 623000
Plan sponsor’s mailing address 955 NW 3 STREET, MIAMI, FL, 33128
Plan sponsor’s address 955 NW 3 STREET, MIAMI, FL, 33128

Plan administrator’s name and address
Administrator’s EIN 311558831
Plan administrator’s name VICTORIA NURSING & REHABILITATION CENTER
Plan administrator’s address 955 NW 3 STREET, MIAMI, FL, 33128
Administrator’s telephone number 3055484020

Number of participants as of the end of the plan year
Active participants 122
Retired or separated participants receiving benefits 1
Other retired or separated participants entitled to future benefits 0
Number of participants with account balances as of the end of the plan year 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2012-09-26
Name of individual signing RALPH STACEY
Valid signature Filed with authorized/valid electronic signature
VICTORIA NURSING & REHABILITATION CENTER 2011 311558831 2012-06-27 VICTORIA NURSING & REHABILITATION CENTER 104
File View Page
Three-digit plan number (PN) 511
Effective date of plan 2005-06-01
Business code 623000
Sponsor’s telephone number 3055484020
Plan sponsor’s mailing address 955 NW 3 STREET, MIAMI, FL, 33128
Plan sponsor’s address 955 NW 3 STREET, MIAMI, FL, 33128

Plan administrator’s name and address
Administrator’s EIN 311558831
Plan administrator’s name VICTORIA NURSING & REHABILITATION CENTER
Plan administrator’s address 955 NW 3 STREET, MIAMI, FL, 33128
Administrator’s telephone number 3055484020

Number of participants as of the end of the plan year
Active participants 107
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Number of participants with account balances as of the end of the plan year 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2012-06-27
Name of individual signing RALPH STACEY
Valid signature Filed with authorized/valid electronic signature
VICTORIA NURSING & REHABILITATION CENTER 2010 311558831 2011-08-12 VICTORIA NURSING & REHABILITATION CENTER 104
File View Page
Three-digit plan number (PN) 510
Effective date of plan 2009-05-01
Business code 623000
Sponsor’s telephone number 3055484020
Plan sponsor’s mailing address 955 NW 3 STREET, MIAMI, FL, 33128
Plan sponsor’s address 955 NW 3 STREET, MIAMI, FL, 33128

Plan administrator’s name and address
Administrator’s EIN 311558831
Plan administrator’s name VICTORIA NURSING & REHABILITATION CENTER
Plan administrator’s address 955 NW 3 STREET, MIAMI, FL, 33128
Administrator’s telephone number 3055484020

Number of participants as of the end of the plan year
Active participants 125
Retired or separated participants receiving benefits 1
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2011-08-12
Name of individual signing RALPH STACEY
Valid signature Filed with authorized/valid electronic signature
VICTORIA NURSING & REHABILITATION CENTER 2010 311558831 2011-08-10 VICTORIA NURSING & REHABILITATION CENTER 104
File View Page
Three-digit plan number (PN) 511
Effective date of plan 2005-06-01
Business code 623000
Sponsor’s telephone number 3055484020
Plan sponsor’s mailing address 955 NW 3 STREET, MIAMI, FL, 33128
Plan sponsor’s address 955 NW 3 STREET, MIAMI, FL, 33128

Plan administrator’s name and address
Administrator’s EIN 311558831
Plan administrator’s name VICTORIA NURSING & REHABILITATION CENTER
Plan administrator’s address 955 NW 3 STREET, MIAMI, FL, 33128
Administrator’s telephone number 3055484020

Number of participants as of the end of the plan year
Active participants 101
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2011-08-10
Name of individual signing RALPH STACEY
Valid signature Filed with authorized/valid electronic signature
VICTORIA NURSING & REHABILITATION CENTER 2009 311558831 2010-05-11 VICTORIA NURSING & REHABILITATION CENTER 132
Three-digit plan number (PN) 510
Effective date of plan 2009-05-01
Business code 623000
Sponsor’s telephone number 3055484020
Plan sponsor’s mailing address 955 NW 3 STREET, MIAMI, FL, 33128
Plan sponsor’s address 955 NW 3 STREET, MIAMI, FL, 33128

Plan administrator’s name and address
Administrator’s EIN 311558831
Plan administrator’s name VICTORIA NURSING & REHABILITATION CENTER
Plan administrator’s address 955 NW 3 STREET, MIAMI, FL, 33128
Administrator’s telephone number 3055484020

Number of participants as of the end of the plan year
Active participants 103
Retired or separated participants receiving benefits 1
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Employer/plan sponsor
Date 2010-05-11
Name of individual signing RALPH STACEY
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
STACEY RICHARD E Director 899 NW 4TH STREET, MIAMI, FL, 33128
STACEY RICHARD E President 899 NW 4TH STREET, MIAMI, FL, 33128
STACEY RICHARD E Agent 899 NW 4TH STREET, MIAMI, FL, 33128

Events

Event Type Filed Date Value Description
AMENDMENT 2011-08-22 - -
CHANGE OF MAILING ADDRESS 2011-02-14 955 NW 3RD ST, MIAMI, FL 33128 -
CHANGE OF PRINCIPAL ADDRESS 2003-04-30 955 NW 3RD ST, MIAMI, FL 33128 -
NAME CHANGE AMENDMENT 1998-03-25 VICTORIA NURSING & REHABILITATION CENTER, INC. -

Debts

Document Number Status Case Number Name of Court Date of Entry Expiration Date Amount Due Plaintiff
J19000628832 LAPSED 2018-030974-CA 01 MIAMI DADE COUNTY, FLORIDA 2019-08-28 2024-09-23 $75,000.00 REGINAL C. DIXON, AS NEXT FRIEND OF ROBERTO MARTINEZ, 1268 N.W. 35 STREET, MIAMI, FL 33142

Documents

Name Date
ANNUAL REPORT 2024-02-29
ANNUAL REPORT 2023-03-06
ANNUAL REPORT 2022-05-18
ANNUAL REPORT 2021-03-22
ANNUAL REPORT 2020-03-09
ANNUAL REPORT 2019-04-04
ANNUAL REPORT 2018-04-25
ANNUAL REPORT 2017-02-16
ANNUAL REPORT 2016-03-08
ANNUAL REPORT 2015-03-16

USAspending Awards. Contracts

Contract Type Award or IDV Flag PIID Start Date Current End Date Potential End Date
- IDV VA248BO0194 2011-02-15 - -
Unique Award Key CONT_IDV_VA248BO0194_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title NURSING HOME CONTRACT
NAICS Code 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product and Service Codes Q402: NURSING HOME CARE CONTRACTS

Recipient Details
Recipient VICTORIA NURSING & REHABILITATION CENTER, INC.
UEI FZZLL5AKPH52
Legacy DUNS 072249204
Recipient Address 955 NW 3RD ST, MIAMI, 331281274, UNITED STATES

Motor Carrier Census

USDOT Number Carrier Operation MCS-150 Form Date MCS-150 Mileage MCS-150 Year Power Units Drivers Operation Classification
2726071 Intrastate Non-Hazmat 2024-01-29 106881 2024 2 2 Priv. Pass. (Business)
Legal Name VICTORIA NURSING & REHABILITATION CENTER INC
DBA Name -
Physical Address 955 NW 3RD ST SUITE105, MIAMI, FL, 33128, US
Mailing Address 955 NW 3RD ST SUITE 105, MIAMI, FL, 33128, US
Phone (305) 548-4020
Fax (305) 777-7200
E-mail YSANDINO@VICTORIANURSING.NET

Safety Measurement System - All Transportation
Total Number of Inspections for the measurement period (24 months) 0
Driver Fitness BASIC Serious Violation Indicator No
Vehicle Maintenance BASIC Acute/Critical Indicator No
Unsafe Driving BASIC Acute/Critical Indicator No
Driver Fitness BASIC Roadside Performance measure value 0
Hours-of-Service (HOS) Compliance BASIC Roadside Performance measure value 0
Total Number of Driver Inspections for the measurment period 0
Vehicle Maintenance BASIC Roadside Performance measure value 0
Total Number of Vehicle Inspections for the measurement period 0
Controlled Substances and Alcohol BASIC Roadside Performance measure value 0
Unsafe Driving BASIC Roadside Performance Measure Value 0
Number of inspections with at least one Driver Fitness BASIC violation 0
Number of inspections with at least one Hours-of-Service BASIC violation 0
Total Number of Driver Inspections containing at least one Driver Out-of-Service Violation 0
Number of inspections with at least one Vehicle Maintenance BASIC violation 0
Total Number of Vehicle Inspections containing at least one Vehicle Out-of-Service violation 0
Number of inspections with at least one Controlled Substances and Alcohol BASIC violation 0
Number of inspections with at least one Unsafe Driving BASIC violation 0

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Companies related by address

No other companies in our directory share the same address as VICTORIA NURSING & REHABILITATION CENTER, INC.

Date of last update: 02 Apr 2025

Sources: Florida Department of State

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