| Entity Name: | CPT OF JACKSONVILLE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 16 Dec 1987 (37 years ago) |
| Date of dissolution: | 26 Sep 2014 (10 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2014 (10 years ago) |
| Document Number: | K07374 |
| FEI/EIN Number | 59-2862583 |
| Address: | 3716 UNIVERSITY BVD. S, 4, JACKSONVILLE, FL 32216 |
| Mail Address: | 3716 UNIVERSITY BVD. S, 4, JACKSONVILLE, FL 32216 |
| ZIP code: | 32216 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1326035924 | 2005-09-29 | 2008-11-19 | 3716 UNIVERSITY BLVD S, SUITE 4, JACKSONVILLE, FL, 322164355, US | 3716 UNIVERSITY BLVD S, SUITE 4, JACKSONVILLE, FL, 322164355, US | |||||||||||||||||||||
|
|||||||||||||||||||||||||
| Phone | +1 904-733-8133 |
Authorized person
| Name | MR. SAM ROGOZINSKI |
| Role | CEO |
| Phone | 9047338133 |
Taxonomy
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD ID |
| Number | Q 34 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ROGOZINSKI, SAM | Agent | 3716 UNIVERSITY BLVD. S, STE #4, JACKSONVILLE, FL 32216 |
| Name | Role | Address |
|---|---|---|
| ROGOZINSKI, SAM | Director | 3716 S. UNIVERSITY BLVD #4, JACKSONVILLE, FL |
| Name | Role | Address |
|---|---|---|
| ROGOZINSKI, SAM | President | 3716 S. UNIVERSITY BLVD #4, JACKSONVILLE, FL |
| Name | Role | Address |
|---|---|---|
| ROGOZINSKI, SAM | Secretary | 3716 S. UNIVERSITY BLVD #4, JACKSONVILLE, FL |
| Name | Role | Address |
|---|---|---|
| ROGOZINSKI, SAM | Treasurer | 3716 S. UNIVERSITY BLVD #4, JACKSONVILLE, FL |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2010-01-12 | 3716 UNIVERSITY BVD. S, 4, JACKSONVILLE, FL 32216 | No data |
| REGISTERED AGENT NAME CHANGED | 2006-01-12 | ROGOZINSKI, SAM | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2006-01-12 | 3716 UNIVERSITY BLVD. S, STE #4, JACKSONVILLE, FL 32216 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2004-01-23 | 3716 UNIVERSITY BVD. S, 4, JACKSONVILLE, FL 32216 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2013-02-20 |
| ANNUAL REPORT | 2012-02-22 |
| ANNUAL REPORT | 2011-01-05 |
| ANNUAL REPORT | 2010-01-12 |
| ANNUAL REPORT | 2009-01-14 |
| ANNUAL REPORT | 2008-01-14 |
| ANNUAL REPORT | 2007-01-03 |
| ANNUAL REPORT | 2006-01-12 |
| ANNUAL REPORT | 2005-01-07 |
| ANNUAL REPORT | 2004-01-23 |
Date of last update: 04 Feb 2025
Sources: Florida Department of State
