| Entity Name: | PHYSICAL THERAPY AND REHABILITATION CLINIC, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 07 Mar 1978 (47 years ago) |
| Document Number: | 561384 |
| FEI/EIN Number | 59-1802009 |
| Address: | 2140 KINGSLEY AVENUE, STE 5, ORANGE PARK, FL 32073 |
| Mail Address: | 2140 KINGSLEY AVENUE, STE 5, ORANGE PARK, FL 32073 |
| ZIP code: | 32073 |
| County: | Clay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1487081345 | 2013-10-08 | 2024-04-02 | 2140 KINGSLEY AVE, SUITE 5, ORANGE PARK, FL, 320735144, US | 2520 COMMERCIAL DR STE C, STARKE, FL, 320917860, US | |||||||||||||||||||
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| Phone | +1 904-272-2830 |
| Fax | 9042728814 |
| Phone | +1 904-386-1257 |
| Fax | 9043681258 |
Authorized person
| Name | JUSTIN WELDON |
| Role | PRESIDENT |
| Phone | 9042722830 |
Taxonomy
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PHYSICAL THERAPY AND REHABILITATION CLINIC INC 401K PLAN | 2011 | 591802009 | 2012-06-18 | PHYSICAL THERAPY AND REHABILITATION CLINIC INC | 12 | |||||||||||||||||||||||||||||||||||||||||
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| Administrator’s EIN | 591802009 |
| Plan administrator’s name | PHYSICAL THERAPY AND REHABILITATION CLINIC INC |
| Plan administrator’s address | 1835 EAST WEST PARKWAY STE 16, FLEMING ISLE, FL, 320030000 |
| Administrator’s telephone number | 9042153958 |
Signature of
| Role | Plan administrator |
| Date | 2012-06-18 |
| Name of individual signing | ALLEN WEISS |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2012-06-18 |
| Name of individual signing | ALLEN WEISS |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2010-01-01 |
| Business code | 621340 |
| Sponsor’s telephone number | 9042153958 |
| Plan sponsor’s address | 1835 EAST WEST PARKWAY, FLEMING ISLE, FL, 000032003 |
Plan administrator’s name and address
| Administrator’s EIN | 591802009 |
| Plan administrator’s name | PHYSICAL THERAPY AND REHABILITATION CLINIC INC |
| Plan administrator’s address | 1835 EAST WEST PARKWAY, FLEMING ISLE, FL, 000032003 |
| Administrator’s telephone number | 9042153958 |
Signature of
| Role | Plan administrator |
| Date | 2011-07-25 |
| Name of individual signing | JUSTIN WELDON |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2011-07-25 |
| Name of individual signing | JUSTIN WELDON |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| Justin, Weldon | Agent | 2140 Kingsley Ave, Suite 5, Orange Park, FL 32073 |
| Name | Role | Address |
|---|---|---|
| Weldon, Justin | President | 2140 KINGSLEY AVENUE, STE 5 ORANGE PARK, FL 32073 |
| Name | Role | Address |
|---|---|---|
| Weldon, Justin | Director | 2140 KINGSLEY AVENUE, STE 5 ORANGE PARK, FL 32073 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G10000060479 | PREFERRED PHYSICAL THERAPY | ACTIVE | 2010-06-30 | 2025-12-31 | No data | 2140 KINGSLEY AVENUE, SUITE 5, ORANGE PARK, FL, 32073 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2023-05-17 | Justin, Weldon | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-05-17 | 2140 Kingsley Ave, Suite 5, Orange Park, FL 32073 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2006-01-03 | 2140 KINGSLEY AVENUE, STE 5, ORANGE PARK, FL 32073 | No data |
| CHANGE OF MAILING ADDRESS | 2006-01-03 | 2140 KINGSLEY AVENUE, STE 5, ORANGE PARK, FL 32073 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-06 |
| ANNUAL REPORT | 2023-05-17 |
| ANNUAL REPORT | 2022-03-02 |
| ANNUAL REPORT | 2021-03-10 |
| ANNUAL REPORT | 2020-06-30 |
| ANNUAL REPORT | 2019-05-04 |
| ANNUAL REPORT | 2018-02-06 |
| ANNUAL REPORT | 2017-04-14 |
| ANNUAL REPORT | 2016-01-25 |
| ANNUAL REPORT | 2015-03-09 |
Date of last update: 05 Feb 2025
Sources: Florida Department of State
