| Entity Name: | PETERSON REHABILITATION, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 19 Aug 1999 (25 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | P99000074174 |
| FEI/EIN Number | 650938075 |
| Address: | 5922 OKEECHOBEE BLVD, WEST PALM BEACH, FL, 33417, US |
| Mail Address: | 5922 OKEECHOBEE BLVD, WEST PALM BEACH, FL, 33417, US |
| ZIP code: | 33417 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1679584866 | 2006-08-11 | 2020-08-22 | 5912 OKEECHOBEE BLVD, WEST PALM BEACH, FL, 334174324, US | 5912 OKEECHOBEE BLVD, WEST PALM BEACH, FL, 334174324, US | |||||||||||||||||||||||||
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| Phone | +1 561-697-8800 |
| Fax | 5616973372 |
Authorized person
| Name | DR. ARTHUR PETERSON |
| Role | CEO |
| Phone | 5616978800 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| License Number | PT8041 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE GROUP NUMBER |
| Number | K1469 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DESAI JAYMIN A | Agent | 5922 OKEECHOBEE BLVD, WEST PALM BEACH, FL, 33417 |
| Name | Role | Address |
|---|---|---|
| DESAI JAYMIN A | President | 5922 OKEECHOBEE BLVD, WEST PALM BEACH, FL, 33417 |
| Name | Role | Address |
|---|---|---|
| DESAI JAYMIN A | Director | 5922 OKEECHOBEE BLVD, WEST PALM BEACH, FL, 33417 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| AMENDMENT | 2018-10-03 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2018-09-06 | DESAI, JAYMIN A | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2017-01-09 | 5922 OKEECHOBEE BLVD, WEST PALM BEACH, FL 33417 | No data |
| CHANGE OF MAILING ADDRESS | 2017-01-09 | 5922 OKEECHOBEE BLVD, WEST PALM BEACH, FL 33417 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-01-09 | 5922 OKEECHOBEE BLVD, WEST PALM BEACH, FL 33417 | No data |
| Name | Date |
|---|---|
| Amendment | 2018-10-03 |
| ANNUAL REPORT | 2018-09-06 |
| ANNUAL REPORT | 2017-01-09 |
| ANNUAL REPORT | 2016-01-25 |
| ANNUAL REPORT | 2015-02-11 |
| ANNUAL REPORT | 2014-02-20 |
| ANNUAL REPORT | 2013-02-11 |
| ANNUAL REPORT | 2012-01-09 |
| ANNUAL REPORT | 2011-02-15 |
| ANNUAL REPORT | 2010-03-31 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
