| Entity Name: | SUMMIT PHYSICAL THERAPY, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 13 May 2019 (6 years ago) |
| Document Number: | L19000128217 |
| FEI/EIN Number | 842308395 |
| Address: | 2219 COUNTY ROAD 220, MIDDLEBURG, FL, 32068, US |
| Mail Address: | 2219 COUNTY ROAD 220, MIDDLEBURG, FL, 32068, US |
| ZIP code: | 32068 |
| County: | Clay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295591022 | 2024-02-28 | 2024-02-28 | 2219 COUNTY ROAD 220 STE 304, MIDDLEBURG, FL, 320687778, US | 2140 KINGSLEY AVE STE 11, ORANGE PARK, FL, 320735129, US | |||||||||||||||||
|
|||||||||||||||||||||
| Phone | +1 904-644-7722 |
| Fax | 9046371532 |
| Phone | +1 904-592-1036 |
Authorized person
| Name | TARA REEVES VOLLERTSEN |
| Role | OWNER |
| Phone | 9046447722 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| VOLLERTSEN TARA | Agent | 2558 Huntington Way, Orange Park, FL, 32073 |
| Name | Role | Address |
|---|---|---|
| VOLLERTSEN TARA | Manager | 2219 COUNTY ROAD 220, MIDDLEBURG, FL, 32068 |
| Vollertsen Zachary | Manager | 2219 COUNTY ROAD 220, MIDDLEBURG, FL, 32068 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2022-03-14 | 2558 Huntington Way, Orange Park, FL 32073 | No data |
| CHANGE OF MAILING ADDRESS | 2020-03-02 | 2219 COUNTY ROAD 220, SUITE 304, MIDDLEBURG, FL 32068 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-01-31 | 2219 COUNTY ROAD 220, SUITE 304, MIDDLEBURG, FL 32068 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-03 |
| ANNUAL REPORT | 2023-03-02 |
| ANNUAL REPORT | 2022-03-14 |
| ANNUAL REPORT | 2021-04-13 |
| ANNUAL REPORT | 2020-01-31 |
| Florida Limited Liability | 2019-05-13 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
