| Entity Name: | NASSAU PHYSICAL THERAPY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 02 Jul 2001 (24 years ago) |
| Date of dissolution: | 24 Sep 2021 (3 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2021 (3 years ago) |
| Document Number: | P01000065393 |
| FEI/EIN Number | 593728630 |
| Address: | 1786 Arbor Drive, Fernandina Beach, FL, 32034, US |
| Mail Address: | 1786 Arbor Drive, Fernandina Beach, FL, 32034-5602, US |
| ZIP code: | 32034 |
| County: | Nassau |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1487872651 | 2007-04-23 | 2011-11-02 | PO BOX 1609, CALLAHAN, FL, 320111609, US | 45390 GREEN AVE, CALLAHAN, FL, 320113711, US | |||||||||||||||||||||||||||||||
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| Phone | +1 904-879-1223 |
| Fax | 9048791223 |
Authorized person
| Name | MRS. SHARON MARINO |
| Role | OFFICE MANAGER |
| Phone | 9042774449 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | PT 5539 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD OF FLORIDA |
| Number | Y927Q |
| State | FL |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | Y907M |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MARINO JAMES | Agent | 1786 Arbor Drive, Fernandina Beach, FL, 320345602 |
| Name | Role | Address |
|---|---|---|
| MARINO JAMES | President | 1786 ARBOR DRIVE, FERNANDINA BEACH, FL, 32034 |
| Name | Role | Address |
|---|---|---|
| MARINO JAMES | Secretary | 1786 ARBOR DRIVE, FERNANDINA BEACH, FL, 32034 |
| Name | Role | Address |
|---|---|---|
| MARINO JAMES | Director | 1786 ARBOR DRIVE, FERNANDINA BEACH, FL, 32034 |
| MARINO SHARON M | Director | 1786 ARBOR DRIVE, FERNANDINA BEACH, FL, 32034 |
| Name | Role | Address |
|---|---|---|
| MARINO SHARON M | Vice President | 1786 ARBOR DRIVE, FERNANDINA BEACH, FL, 32034 |
| Name | Role | Address |
|---|---|---|
| MARINO SHARON M | Treasurer | 1786 ARBOR DRIVE, FERNANDINA BEACH, FL, 32034 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-03-12 | 1786 Arbor Drive, Fernandina Beach, FL 32034 | No data |
| CHANGE OF MAILING ADDRESS | 2020-03-12 | 1786 Arbor Drive, Fernandina Beach, FL 32034 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-03-12 | 1786 Arbor Drive, Fernandina Beach, FL 32034-5602 | No data |
| AMENDMENT | 2008-03-31 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2020-03-12 |
| ANNUAL REPORT | 2019-04-03 |
| ANNUAL REPORT | 2018-03-28 |
| ANNUAL REPORT | 2017-03-14 |
| ANNUAL REPORT | 2016-03-09 |
| ANNUAL REPORT | 2015-01-09 |
| ANNUAL REPORT | 2014-03-01 |
| ANNUAL REPORT | 2013-04-12 |
| ANNUAL REPORT | 2012-03-19 |
| ANNUAL REPORT | 2011-06-29 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
