| Entity Name: | PARKWAY PHYSICAL THERAPY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 07 Nov 1989 (35 years ago) |
| Document Number: | L28681 |
| FEI/EIN Number | 650155668 |
| Address: | 14421 METROPOLIS AVE, SUITE 103, FORT MYERS, FL, 33912, US |
| Mail Address: | PO BOX 491654, LEESBURG, FL, 34749-1654, US |
| ZIP code: | 33912 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538384136 | 2007-04-17 | 2008-07-15 | PO BOX 491654, LEESBURG, FL, 347491654, US | 600 W NORTH BLVD, LEESBURG, FL, 347485063, US | |||||||||||||||||||||
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| Phone | +1 352-787-9300 |
Authorized person
| Name | MR. GERALD GOLDSTEIN |
| Role | VICE PRESIDENT |
| Phone | 3527879300 |
Taxonomy
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS FACILITY NUMBER |
| Number | Y910 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GOLDSTEIN GERALD | Agent | 2918 COCOVIA WAY, LEESBURG, FL, 34748 |
| Name | Role | Address |
|---|---|---|
| GOLDSTEIN ROBERT J | President | 33210 COVENTRY DR, LEESBURG, FL, 34788 |
| Name | Role | Address |
|---|---|---|
| GOLDSTEIN ROBERT J | Treasurer | 33210 COVENTRY DR, LEESBURG, FL, 34788 |
| Name | Role | Address |
|---|---|---|
| GOLDSTEIN ROBERT J | Director | 33210 COVENTRY DR, LEESBURG, FL, 34788 |
| GOLDSTEIN GERALD | Director | 2918 COCOVIA WAY, LEESBURG, FL, 34748 |
| Name | Role | Address |
|---|---|---|
| GOLDSTEIN GERALD | Vice President | 2918 COCOVIA WAY, LEESBURG, FL, 34748 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| AMENDMENT | 1989-12-15 | No data | No data |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
