| Entity Name: | MIAMI-DADE PHYSICAL REHABILITATION, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 26 Jun 1998 (27 years ago) |
| Document Number: | P98000057861 |
| FEI/EIN Number | 208530157 |
| Address: | 1840 W. 49 STREET, SUITE 310, HIALEAH, FL, 33012 |
| Mail Address: | 1840 W. 49 STREET, SUITE 310, HIALEAH, FL, 33012 |
| ZIP code: | 33012 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265683338 | 2008-10-07 | 2008-10-07 | 1840 W 49 STREET, SUITE 310, HIALEAH, FL, 33012, US | 1840 W 49 STREET, HIALEAH, FL, 33012, US | |||||||||||||||||||||||
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| Phone | +1 305-698-0161 |
| Fax | 3056980262 |
Authorized person
| Name | JOSE LUIS CASTILLO |
| Role | OWNER |
| Phone | 3054903103 |
Taxonomy
| Taxonomy Code | 261QR0401X - Comprehensive Outpatient Rehabilitation Facility (CORF) |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE |
| Number | 684534 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CASTILLO JOSE LUIS | Agent | 1840 WEST 49TH STREET, STE 310, HIALEAH, FL, 33012 |
| Name | Role | Address |
|---|---|---|
| CASTILLO JOSE LUIS | PTST | 1840 W. 49TH ST., SUITE 310, HIALEAH, FL, 33012 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| AMENDMENT | 2008-10-07 | No data | No data |
| CANCEL ADM DISS/REV | 2008-10-02 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2008-09-26 | No data | No data |
| AMENDMENT | 2007-01-02 | No data | No data |
| AMENDMENT | 2005-02-28 | No data | No data |
| AMENDMENT | 2002-08-02 | No data | No data |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
