| Entity Name: | PERSONAL REHAB, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 30 Jul 1999 (26 years ago) |
| Date of dissolution: | 23 Sep 2022 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (2 years ago) |
| Document Number: | P99000069821 |
| FEI/EIN Number | 650936848 |
| Address: | 104 S. MAIN AVE, LAKE PLACID, FL, 33852 |
| Mail Address: | 104 S. MAIN AVE, LAKE PLACID, FL, 33852 |
| ZIP code: | 33852 |
| County: | Highlands |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1033173265 | 2006-04-14 | 2010-03-23 | 104 S MAIN AVE, LAKE PLACID, FL, 338521808, US | 104 S MAIN AVE, LAKE PLACID, FL, 338521808, US | |||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||
| Phone | +1 863-699-6929 |
Authorized person
| Name | RENE SMIT |
| Role | OWNER |
| Phone | 8636996929 |
Taxonomy
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| License Number | PT0005726 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | RAILROAD MEDICARE |
| Number | DC0334 |
| State | FL |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | Y909E |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SMIT RENE | Agent | 104 S. MAIN AVE, LAKE PLACID, FL, 33852 |
| Name | Role | Address |
|---|---|---|
| SMIT MARY | Treasurer | 104 S. MAIN AVE, LAKE PLACID, FL, 33852 |
| Name | Role | Address |
|---|---|---|
| SMIT RENE | Director | 104 S. MAIN AVE, LAKE PLACID, FL, 33852 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| REINSTATEMENT | 2015-08-17 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2015-08-17 | SMIT, RENE | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| CANCEL ADM DISS/REV | 2009-10-08 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| AMENDMENT | 2005-08-15 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2005-02-03 | 104 S. MAIN AVE, LAKE PLACID, FL 33852 | No data |
| CHANGE OF MAILING ADDRESS | 2005-02-03 | 104 S. MAIN AVE, LAKE PLACID, FL 33852 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2005-02-03 | 104 S. MAIN AVE, LAKE PLACID, FL 33852 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2021-01-12 |
| ANNUAL REPORT | 2020-01-18 |
| ANNUAL REPORT | 2019-01-27 |
| ANNUAL REPORT | 2018-01-15 |
| ANNUAL REPORT | 2017-01-10 |
| ANNUAL REPORT | 2016-02-13 |
| REINSTATEMENT | 2015-08-17 |
| ANNUAL REPORT | 2013-02-09 |
| ANNUAL REPORT | 2012-02-05 |
| ANNUAL REPORT | 2011-02-01 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
