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  5. ORTHOPEDIC PHYSICAL THERAPY ASSOCIATES LLC

ORTHOPEDIC PHYSICAL THERAPY ASSOCIATES LLC

Company Details

Entity Name: ORTHOPEDIC PHYSICAL THERAPY ASSOCIATES LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 21 Apr 2005 (20 years ago)
Document Number: L05000038815
FEI/EIN Number 202714530
Address: 4720 CLEVELAND HEIGHTS BLVD., SUITE 101, LAKELAND, FL, 33813, US
Mail Address: 4720 CLEVELAND HEIGHTS BLVD., SUITE 101, LAKELAND, FL, 33813, US
ZIP code: 33813
County: Polk
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1114995891 2006-03-09 2007-11-20 4720 CLEVELAND HEIGHTS BLVD, SUITE 101, LAKELAND, FL, 338132243, US 4720 CLEVELAND HEIGHTS BLVD, SUITE 101, LAKELAND, FL, 338132243, US

Contacts
Phone +1 863-644-0007
Fax 8636443377

Authorized person
Name PATRICIA ANNE ROULEAU
Role OWNER
Phone 8636440007

Taxonomy
Taxonomy Code 225100000X - Physical Therapist
State FL
Is Primary Yes

Other Provider Identifiers
Issuer BCBS GROUP NUMBER
Number Y917E
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ORTHOPEDIC PHYSICAL THERAPY ASSOCIATES, LLC 401(K) PROFIT SHARING PLAN 2015 202714530 2016-10-10 ORTHOPEDIC PHYSICAL THERAPY ASSOCIATES, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621340
Sponsor’s telephone number 8636440007
Plan sponsor’s address 4720 CLEVELAND HEIGHTS BLVD., SUITE, LAKELAND, FL, 33813

Signature of
Role Plan administrator
Date 2016-10-10
Name of individual signing PATRICIA ROULEAU
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-10-10
Name of individual signing PATRICIA ROULEAU
Valid signature Filed with authorized/valid electronic signature
ORTHOPEDIC PHYSICAL THERAPY ASSOCIATES, LLC 401(K) PROFIT SHARING PLAN & TRUS 2014 202714530 2015-02-12 ORTHOPEDIC PHYSICAL THERAPY ASSOCIATES, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621340
Sponsor’s telephone number 8636440007
Plan sponsor’s address 4720 CLEVELAND HEIGHTS BLVD, #101, LAKELAND, FL, 338132244

Signature of
Role Plan administrator
Date 2015-02-12
Name of individual signing ROBERT P. ROULEAU
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-02-12
Name of individual signing ROBERT P. ROULEAU
Valid signature Filed with authorized/valid electronic signature
ORTHOPEDIC PHYSICAL THERAPY ASSOCIATES, LLC 401(K) PROFIT SHARING PLAN & TRUS 2013 202714530 2014-02-18 ORTHOPEDIC PHYSICAL THERAPY ASSOCIATES, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621340
Sponsor’s telephone number 8636440007
Plan sponsor’s address 4720 CLEVELAND HEIGHTS BLVD, #101, LAKELAND, FL, 338132244

Signature of
Role Plan administrator
Date 2014-02-17
Name of individual signing PATRICIA ROULEAU
Valid signature Filed with authorized/valid electronic signature
ORTHOPEDIC PHYSICAL THERAPY ASSOCIATES, LLC 401(K) PROFIT SHARING PLAN & TRUS 2012 202714530 2013-07-25 ORTHOPEDIC PHYSICAL THERAPY ASSOCIATES, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621340
Sponsor’s telephone number 8636440007
Plan sponsor’s address 4720 CLEVELAND HEIGHTS BLVD, #101, LAKELAND, FL, 338132244

Signature of
Role Plan administrator
Date 2013-07-25
Name of individual signing PATRICIA ROULEAU
Valid signature Filed with authorized/valid electronic signature
ORTHOPEDIC PHYSICAL THERAPY ASSOCIATES, LLC 401(K) PROFIT SHARING PLAN & TRUS 2011 202714530 2012-02-29 ORTHOPEDIC PHYSICAL THERAPY ASSOCIATES, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621340
Sponsor’s telephone number 8636440007
Plan sponsor’s address 4720 CLEVELAND HEIGHTS BLVD, #101, LAKELAND, FL, 338132244

Plan administrator’s name and address
Administrator’s EIN 202714530
Plan administrator’s name ORTHOPEDIC PHYSICAL THERAPY ASSOCIATES, LLC
Plan administrator’s address 4720 CLEVELAND HEIGHTS BLVD, #101, LAKELAND, FL, 338132244
Administrator’s telephone number 8636440007

Signature of
Role Plan administrator
Date 2012-02-27
Name of individual signing PATRICIA ROULEAU
Valid signature Filed with authorized/valid electronic signature
ORTHOPEDIC PHYSICAL THERAPY ASSOCIATES, LLC 401(K) PROFIT SHARING PLAN & TRUS 2010 202714530 2011-02-28 ORTHOPEDIC PHYSICAL THERAPY ASSOCIATES, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621340
Sponsor’s telephone number 8636440007
Plan sponsor’s address 4720 CLEVELAND HEIGHTS BLVD, #101, LAKELAND, FL, 338132244

Plan administrator’s name and address
Administrator’s EIN 202714530
Plan administrator’s name ORTHOPEDIC PHYSICAL THERAPY ASSOCIATES, LLC
Plan administrator’s address 4720 CLEVELAND HEIGHTS BLVD, #101, LAKELAND, FL, 338132244
Administrator’s telephone number 8636440007

Signature of
Role Plan administrator
Date 2011-02-28
Name of individual signing PATRICIA ROULEAU
Valid signature Filed with authorized/valid electronic signature
ORTHOPEDIC PHYSICAL THERAPY ASSOCIATES, LLC 401(K) PROFIT SHARING PLAN & TRUS 2009 202714530 2010-07-01 ORTHOPEDIC PHYSICAL THERAPY ASSOCIATES, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621340
Sponsor’s telephone number 8636440007
Plan sponsor’s address 4720 CLEVELAND HEIGHTS BLVD, #101, LAKELAND, FL, 338132244

Plan administrator’s name and address
Administrator’s EIN 202714530
Plan administrator’s name ORTHOPEDIC PHYSICAL THERAPY ASSOCIATES, LLC
Plan administrator’s address 4720 CLEVELAND HEIGHTS BLVD, #101, LAKELAND, FL, 338132244
Administrator’s telephone number 8636440007

Signature of
Role Plan administrator
Date 2010-06-30
Name of individual signing PATRICIA ROULEAU
Valid signature Filed with authorized/valid electronic signature
ORTHOPEDIC PHYSICAL THERAPY ASSOCIATES, LLC 401(K) PROFIT SHARING PLAN & TRUS 2009 202714530 2010-06-29 ORTHOPEDIC PHYSICAL THERAPY ASSOCIATES, LLC 3
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621340
Sponsor’s telephone number 8636440007
Plan sponsor’s address 4720 CLEVELAND HEIGHTS BLVD, #101, LAKELAND, FL, 338132244

Plan administrator’s name and address
Administrator’s EIN 202714530
Plan administrator’s name ORTHOPEDIC PHYSICAL THERAPY ASSOCIATES, LLC
Plan administrator’s address 4720 CLEVELAND HEIGHTS BLVD, #101, LAKELAND, FL, 338132244
Administrator’s telephone number 8636440007

Signature of
Role Employer/plan sponsor
Date 2010-06-26
Name of individual signing PATRICIA ROULEAU
Valid signature Filed with authorized/valid electronic signature
ORTHOPEDIC PHYSICAL THERAPY ASSOCIATES, LLC 401(K) PROFIT SHARING PLAN & TRUS 2009 202714530 2010-06-22 ORTHOPEDIC PHYSICAL THERAPY ASSOCIATES, LLC 3
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621340
Sponsor’s telephone number 8636440007
Plan sponsor’s address 4720 CLEVELAND HEIGHTS BLVD, #101, LAKELAND, FL, 338132244

Plan administrator’s name and address
Administrator’s EIN 202714530
Plan administrator’s name ORTHOPEDIC PHYSICAL THERAPY ASSOCIATES, LLC
Plan administrator’s address 4720 CLEVELAND HEIGHTS BLVD, #101, LAKELAND, FL, 338132244
Administrator’s telephone number 8636440007

Agent

Name Role Address
ROULEAU ROBERT P Agent 4518 HALLAM HILL LANE, LAKELAND, FL, 33813

Manager

Name Role Address
ROULEAU ROBERT P Manager 4518 HALLAM HILL LANE, LAKELAND, FL, 33813
ROULEAU PATRICIA A Manager 4518 HALLAM HILL LANE, LAKELAND, FL, 33813

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2006-01-12 4720 CLEVELAND HEIGHTS BLVD., SUITE 101, LAKELAND, FL 33813 No data
CHANGE OF MAILING ADDRESS 2006-01-12 4720 CLEVELAND HEIGHTS BLVD., SUITE 101, LAKELAND, FL 33813 No data

Documents

Name Date
ANNUAL REPORT 2024-01-22
ANNUAL REPORT 2023-01-27
ANNUAL REPORT 2022-01-26
ANNUAL REPORT 2021-01-09
ANNUAL REPORT 2020-01-16
ANNUAL REPORT 2019-03-12
ANNUAL REPORT 2018-01-16
ANNUAL REPORT 2017-01-10
ANNUAL REPORT 2016-01-28
ANNUAL REPORT 2015-01-13

Related by officers

ROULEAU ROBERT P

ORTHOPEDIC HOME PHYSICAL THERAPY CORP

ROULEAU PATRICIA A

ORTHOPEDIC HOME PHYSICAL THERAPY CORP

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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