| Entity Name: | INDIAN RIVER REHABILITATION MEDICINE CLINIC. P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 15 Sep 1999 (25 years ago) |
| Date of dissolution: | 24 Sep 2021 (3 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2021 (3 years ago) |
| Document Number: | P99000083370 |
| FEI/EIN Number | 16-1566997 |
| Address: | 2050 13th Avenue #2692, VERO BEACH, FL 32960 |
| Mail Address: | 1500-B 14TH AVE, VERO BEACH, FL 32960 |
| ZIP code: | 32960 |
| County: | Indian River |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598065732 | 2010-10-21 | 2010-11-22 | P O BOX 2692, VERO BEACH, FL, 329612692, US | 631 17TH STREET, VERO BEACH, FL, 329605518, US | |||||||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 772-778-1603 |
| Fax | 7722318470 |
Authorized person
| Name | DR. IHEONU USOUWA ORIAKU |
| Role | PRESIDENT/ MEDICAL DIRECTOR |
| Phone | 7726434208 |
Taxonomy
| Taxonomy Code | 207P00000X - Emergency Medicine Physician |
| License Number | ME79198 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ME79198 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| License Number | ME79198 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 259802700 |
| State | FL |
| Issuer | MEDICARE |
| Number | 49280 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ORIAKU, IHEONU U | Agent | 2050 13th Avenue, #2692, Vero Beach, FL 32960 |
| Name | Role | Address |
|---|---|---|
| ORIAKU, IHEONU U | Director | 2050 13th Avenue #2692, VERO BEACH, FL 32960 |
| Name | Role | Address |
|---|---|---|
| ORIAKU, IHEONU U | President | 2050 13th Avenue #2692, VERO BEACH, FL 32960 |
| Name | Role | Address |
|---|---|---|
| ORIAKU, IHEONU U | Treasurer | 2050 13th Avenue #2692, VERO BEACH, FL 32960 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000050639 | GLOBAL PPE PROCUREMENT AND SUPPLIES | ACTIVE | 2020-05-07 | 2025-12-31 | No data | 2050 13TH AVENUE, UNIT 2692, VERO BEACH, FL, 32961 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-04-28 | 2050 13th Avenue, #2692, Vero Beach, FL 32960 | No data |
| REINSTATEMENT | 2017-04-28 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2017-04-28 | 2050 13th Avenue #2692, VERO BEACH, FL 32960 | No data |
| REGISTERED AGENT NAME CHANGED | 2017-04-28 | ORIAKU, IHEONU U | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| REINSTATEMENT | 2012-05-01 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2010-04-30 | 2050 13th Avenue #2692, VERO BEACH, FL 32960 | No data |
| REINSTATEMENT | 2001-10-01 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J12001045619 | TERMINATED | 1000000432085 | INDIAN RIV | 2012-12-12 | 2022-12-19 | $ 350.00 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, FORT PIERCE SERVICE CENTER, 337 N US HIGHWAY 1 STE 207-B, FORT PIERCE FL349504255 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2020-04-23 |
| ANNUAL REPORT | 2019-04-29 |
| ANNUAL REPORT | 2018-04-30 |
| REINSTATEMENT | 2017-04-28 |
| ANNUAL REPORT | 2015-05-01 |
| ANNUAL REPORT | 2014-04-30 |
| ANNUAL REPORT | 2013-04-30 |
| REINSTATEMENT | 2012-05-01 |
| ANNUAL REPORT | 2010-04-30 |
| ANNUAL REPORT | 2009-04-30 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
