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  5. PROVIDIAN FUNCTIONAL CAPACITY SPECIALISTS, LLC

PROVIDIAN FUNCTIONAL CAPACITY SPECIALISTS, LLC - Florida Company Profile

Company Details

Entity Name: PROVIDIAN FUNCTIONAL CAPACITY SPECIALISTS, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

PROVIDIAN FUNCTIONAL CAPACITY SPECIALISTS, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act
Status: Inactive

The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders.

Date Filed: 23 Jan 2004 (21 years ago)
Date of dissolution: 29 Apr 2016 (9 years ago)
Last Event: CORPORATE MERGER
Event Date Filed: 29 Apr 2016 (9 years ago)
Document Number: L04000006169
FEI/EIN Number 753144487

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 7785 BAYMEADOWS WAY, STE. 302, JACKSONVILLE, FL, 32256, US
Mail Address: 7785 BAYMEADOWS WAY, STE. 302, JACKSONVILLE, FL, 32256, US
ZIP code: 32256
County: Duval
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1013258862 2013-03-04 2013-03-04 716 N ORANGE AVE, GREEN COVE SPRINGS, FL, 320432920, US 716 N ORANGE AVE, GREEN COVE SPRINGS, FL, 320432920, US

Contacts
Phone +1 888-957-3337
Fax 9042844244

Authorized person
Name MR. BRIAN SCOTT IMLER
Role PRESIDENT
Phone 9049825762

Taxonomy
Taxonomy Code 261QP2000X - Physical Therapy Clinic/Center
License Number AL1714
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PROVIDIAN FUNCTIONAL CAPACITY SPECIALISTS 401(K) PLAN 2013 753144487 2014-03-14 PROVIDIAN FUNCTIONAL CAPACITY SPECIALISTS LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621399
Sponsor’s telephone number 9049829762
Plan sponsor’s address 3675 WINGED FOOT CIRCLE, GREEN COVE SPRINGS, FL, 32043

Signature of
Role Plan administrator
Date 2014-03-13
Name of individual signing BRIAN IMLER
Valid signature Filed with authorized/valid electronic signature
PROVIDIAN FUNCTIONAL CAPACITY SPECIALISTS 401(K) PLAN 2012 753144487 2013-10-14 PROVIDIAN FUNCTIONAL CAPACITY SPECIALISTS LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621399
Sponsor’s telephone number 9049829762
Plan sponsor’s address P.O. BOX 9539, FLEMING ISLAND, FL, 32006

Signature of
Role Plan administrator
Date 2013-10-14
Name of individual signing BRIAN IMLER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-10-14
Name of individual signing BRIAN IMLER
Valid signature Filed with authorized/valid electronic signature
PROVIDIAN FUNCTIONAL CAPACITY SPECIALISTS 401(K) PLAN 2011 753144487 2012-07-25 PROVIDIAN FUNCTIONAL CAPACITY SPECIALISTS LLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621399
Sponsor’s telephone number 9049829762
Plan sponsor’s address P.O. BOX 9539, FLEMING ISLAND, FL, 32006

Plan administrator’s name and address
Administrator’s EIN 753144487
Plan administrator’s name PROVIDIAN FUNCTIONAL CAPACITY SPECIALISTS LLC
Plan administrator’s address P.O. BOX 9539, FLEMING ISLAND, FL, 32006
Administrator’s telephone number 9049829762

Signature of
Role Plan administrator
Date 2012-07-25
Name of individual signing BRIAN IMLER
Valid signature Filed with authorized/valid electronic signature
PROVIDIAN FUNCTIONAL CAPACITY SPECIALISTS 401(K) PLAN 2010 753144487 2011-09-26 PROVIDIAN FUNCTIONAL CAPACITY SPECIALISTS LLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621399
Sponsor’s telephone number 9049829762
Plan sponsor’s address P.O. BOX 9539, FLEMING ISLAND, FL, 32006

Plan administrator’s name and address
Administrator’s EIN 753144487
Plan administrator’s name PROVIDIAN FUNCTIONAL CAPACITY SPECIALISTS LLC
Plan administrator’s address P.O. BOX 9539, FLEMING ISLAND, FL, 32006
Administrator’s telephone number 9049829762

Signature of
Role Plan administrator
Date 2011-09-26
Name of individual signing BRIAN IMLER
Valid signature Filed with authorized/valid electronic signature
PROVIDIAN FUNCTIONAL CAPACITY SPECIALISTS 401(K) PLAN 2009 753144487 2010-09-29 PROVIDIAN FUNCTIONAL CAPACITY SPECIALISTS LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621399
Sponsor’s telephone number 9049829762
Plan sponsor’s address P.O. BOX 9539, FLEMING ISLAND, FL, 32006

Plan administrator’s name and address
Administrator’s EIN 753144487
Plan administrator’s name PROVIDIAN FUNCTIONAL CAPACITY SPECIALISTS LLC
Plan administrator’s address P.O. BOX 9539, FLEMING ISLAND, FL, 32006
Administrator’s telephone number 9049829762

Signature of
Role Plan administrator
Date 2010-09-29
Name of individual signing BRIAN IMLER
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
ALIGN NETWORKS SUB, INC. Managing Member 7785 BAYMEADOWS WAY, STE. 302, JACKSONVILLE, FL, 32256
CORPORATE CREATIONS NETWORK INC. Agent -

Events

Event Type Filed Date Value Description
MERGER 2016-04-29 - CORPORATION WAS PART OF A MERGER. NON-QUALIFIED CORPORATION WAS ALIGN NETWORKS SUB INC. MERGER NUMBER 900000160479
REGISTERED AGENT ADDRESS CHANGED 2014-04-17 11380 PROSPERITY FARMS ROAD #221E, PALM BEACH GARDENS, FL 33410 -
LC STMNT OF RA/RO CHG 2014-04-17 - -
REGISTERED AGENT NAME CHANGED 2014-04-17 CORPORATE CREATIONS NETWORK, INC. -
CHANGE OF PRINCIPAL ADDRESS 2013-10-03 7785 BAYMEADOWS WAY, STE. 302, JACKSONVILLE, FL 32256 -
CHANGE OF MAILING ADDRESS 2013-10-03 7785 BAYMEADOWS WAY, STE. 302, JACKSONVILLE, FL 32256 -
LC AMENDMENT 2013-10-03 - -
CANCEL ADM DISS/REV 2009-12-07 - -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2008-09-26 - -
AMENDMENT 2004-02-25 - -

Documents

Name Date
Merger 2016-04-29
ANNUAL REPORT 2016-01-13
ANNUAL REPORT 2015-01-15
CORLCRACHG 2014-04-17
ANNUAL REPORT 2014-03-11
LC Amendment 2013-10-03
ANNUAL REPORT 2013-04-12
ANNUAL REPORT 2012-04-25
ANNUAL REPORT 2011-04-27
ANNUAL REPORT 2010-04-18

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Companies related by address

No other companies in our directory share the same address as PROVIDIAN FUNCTIONAL CAPACITY SPECIALISTS, LLC

Date of last update: 03 Apr 2025

Sources: Florida Department of State

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