| Entity Name: | REGIONAL PHYSIOTHERAPY CENTRE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 12 Oct 1988 (36 years ago) |
| Document Number: | K38314 |
| FEI/EIN Number | 650079563 |
| Address: | 901 NORTH FLAGLER DRIVE, SUITE 1, WEST PALM BEACH, FL, 33401, US |
| Mail Address: | 901 NORTH FLAGLER DRIVE, SUITE 1, WEST PALM BEACH, FL, 33401, US |
| ZIP code: | 33401 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1396792479 | 2006-05-27 | 2015-09-02 | 901 NORTH FLAGLER DRIVE, SUITE 1, WEST PALM BEACH, FL, 33401, US | 901 NORTH FLAGLER DRIVE, SUITE 1, WEST PALM BEACH, FL, 33401, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 561-833-2244 |
| Fax | 5618332281 |
Authorized person
| Name | MR. DAVID LIGHT |
| Role | PRESIDENT |
| Phone | 5618332244 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | UNITED HEALTHCARE |
| Number | 00000606815 01 |
| State | FL |
| Issuer | AETNA |
| Number | 5663296 |
| State | FL |
| Issuer | BCBS OF FLORIDA |
| Number | Y913P |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LIGHT DAVID M | Agent | 901 NORTH FLAGLER DRIVE, WEST PALM BEACH, FL, 33401 |
| Name | Role | Address |
|---|---|---|
| LIGHT DAVID M | President | 901 NORTH FLAGLER DRIVE, SUITE 1, W PALM BEACH, FL, 33401 |
| Name | Role | Address |
|---|---|---|
| Light Kelley | Vice President | 901 NORTH FLAGLER DRIVE, WEST PALM BEACH, FL, 33401 |
| Young Paul | Vice President | 901 NORTH FLAGLER DRIVE, WEST PALM BEACH, FL, 33401 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G13000074010 | AXON, SCHOOL OF MASSAGE THERAPY | EXPIRED | 2013-07-24 | 2018-12-31 | No data | 5601 OKEECHOBEE BLVD, SUITE B, WEST PALM BEACH, FL, 33417 |
| G12000064336 | REGIONAL PHYSIOTHERAPY CENTRE, SCHOOL OF MASSAGE THERAPY | EXPIRED | 2012-06-26 | 2017-12-31 | No data | 5601 OKEECHOBEE BLVD, SUITE B, WEST PALM BEACH, FL, 33417 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2020-02-10 | No data | No data |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
