| Entity Name: | RICHARD JOHANSEN PHYSICAL THERAPY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 13 Sep 2001 (23 years ago) |
| Date of dissolution: | 23 Sep 2016 (8 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2016 (8 years ago) |
| Document Number: | P01000090878 |
| FEI/EIN Number | 593757032 |
| Address: | 17 NW 33RD CT, GAINESVILLE, FL, 32607, US |
| Mail Address: | 8215 NW 4TH PL, GAINESVILLE, FL, 32607, US |
| ZIP code: | 32607 |
| County: | Alachua |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982691176 | 2005-10-03 | 2008-04-02 | 17 NW 33RD CT, GAINESVILLE, FL, 326072552, US | 17 NW 33RD CT, GAINESVILLE, FL, 326072552, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 352-372-8790 |
| Fax | 3523728908 |
Authorized person
| Name | MR. RICHARD A JOHANSEN |
| Role | PRESIDENT |
| Phone | 3523728970 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| License Number | PT5622 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | Y5403 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| JOHANSEN RICHARD P | Agent | 17 NW 33RD CT, GAINESVILLE, FL, 32607 |
| Name | Role | Address |
|---|---|---|
| JOHANSEN RICHARD | President | 8215 NW 4TH PL, GAINESVILLE, FL, 32607 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-01-05 | 17 NW 33RD CT, GAINESVILLE, FL 32607 | No data |
| CHANGE OF MAILING ADDRESS | 2009-01-05 | 17 NW 33RD CT, GAINESVILLE, FL 32607 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-01-05 | 17 NW 33RD CT, GAINESVILLE, FL 32607 | No data |
| REGISTERED AGENT NAME CHANGED | 2003-01-13 | JOHANSEN, RICHARD P.T. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2015-02-17 |
| ANNUAL REPORT | 2014-04-14 |
| ANNUAL REPORT | 2013-04-04 |
| ANNUAL REPORT | 2012-05-01 |
| ANNUAL REPORT | 2011-03-01 |
| ANNUAL REPORT | 2010-02-22 |
| ANNUAL REPORT | 2009-01-05 |
| ANNUAL REPORT | 2008-01-23 |
| ANNUAL REPORT | 2007-03-19 |
| ANNUAL REPORT | 2006-02-10 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
