| Entity Name: | YOUNG PAIN & REHAB CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 17 Feb 1999 (26 years ago) |
| Date of dissolution: | 26 Sep 2008 (16 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2008 (16 years ago) |
| Document Number: | P99000015365 |
| FEI/EIN Number | 59-3561623 |
| Address: | 7520 WEST WATERS AVENUE, SUITE 12, TAMPA, FL 33615 |
| Mail Address: | 7520 WEST WATERS AVENUE, SUITE 12, TAMPA, FL 33615 |
| ZIP code: | 33615 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1275671158 | 2007-02-02 | 2020-08-22 | 7520 W WATERS AVE, SUITE 12, TAMPA, FL, 336151599, US | 7520 W WATERS AVE, SUITE 12, TAMPA, FL, 336151599, US | |||||||||||||||||||||||||||||
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| Phone | +1 813-884-3773 |
| Fax | 8138843855 |
Authorized person
| Name | YOUNG SOO SUH |
| Role | P.T. DIRECTOR |
| Phone | 8138843773 |
Taxonomy
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| License Number | MM 13883 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 302R00000X - Health Maintenance Organization |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BLUECROSS-BLUESHIELD |
| Number | Y6059 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| KIM, JAE H | Agent | 1502 W. BUSCH BLVD, STE A2, TAMPA, FL 33612 |
| Name | Role | Address |
|---|---|---|
| SUH, YOUNGSOO | President | 7520 WEST WATERS AVENUE, TAMPA, FL 33615 |
| Name | Role | Address |
|---|---|---|
| SUH, YOUNGSOO | Secretary | 7520 WEST WATERS AVENUE, TAMPA, FL 33615 |
| Name | Role | Address |
|---|---|---|
| SUH, YOUNGSOO | Treasurer | 7520 WEST WATERS AVENUE, TAMPA, FL 33615 |
| Name | Role | Address |
|---|---|---|
| SUH, YOUNGSOO | Director | 7520 WEST WATERS AVENUE, TAMPA, FL 33615 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2008-09-26 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2000-05-11 | KIM, JAE H | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2000-05-11 | 1502 W. BUSCH BLVD, STE A2, TAMPA, FL 33612 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2007-04-27 |
| ANNUAL REPORT | 2006-05-01 |
| ANNUAL REPORT | 2005-05-01 |
| ANNUAL REPORT | 2004-05-03 |
| ANNUAL REPORT | 2003-05-02 |
| ANNUAL REPORT | 2002-04-30 |
| ANNUAL REPORT | 2001-03-02 |
| ANNUAL REPORT | 2000-05-11 |
| Domestic Profit | 1999-02-17 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
