| Entity Name: | PALM CITY PHYSICAL THERAPY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 18 Nov 2002 (22 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 23 Aug 2024 (6 months ago) |
| Document Number: | P02000124454 |
| FEI/EIN Number | 320044086 |
| Address: | 3539 SW CORPORATE PARKWAY, PALM CITY, FL, 34990, US |
| Mail Address: | 3539 SW CORPORATE PARKWAY, PALM CITY, FL, 34990, US |
| ZIP code: | 34990 |
| County: | Martin |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1487710513 | 2007-01-01 | 2020-08-22 | 2684 SW IMMANUEL DR, PALM CITY, FL, 349902738, US | 2684 SW IMMANUEL DR, PALM CITY, FL, 349902738, US | |||||||||||||||||||||||||
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| Phone | +1 772-220-3444 |
| Fax | 7722203839 |
Authorized person
| Name | MS. KAY KEELING DEERMAN |
| Role | PHYSICAL THERAPIST |
| Phone | 7722203444 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| License Number | PT2232 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS PROVIDER NUMBER |
| Number | Y907J |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BHATT DRASHTI | Agent | 3539 SW CORPORATE PARKWAY, PALM CITY, FL, 34990 |
| Name | Role | Address |
|---|---|---|
| BHATT DRASHTI | President | 3539 SW CORPORATE PARKWAY, PALM CITY, FL, 34990 |
| Name | Role | Address |
|---|---|---|
| BHATT DRASHTI | Treasurer | 3539 SW CORPORATE PARKWAY, PALM CITY, FL, 34990 |
| Name | Role | Address |
|---|---|---|
| BHATT DRASHTI | Director | 3539 SW CORPORATE PARKWAY, PALM CITY, FL, 34990 |
| Name | Role | Address |
|---|---|---|
| PATEL PRUTHIL | Vice President | 3539 SW CORPORATE PARKWAY, PALM CITY, FL, 34990 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2024-08-23 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2024-08-23 | BHATT, DRASHTI | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-08-23 | 3539 SW CORPORATE PARKWAY, PALM CITY, FL 34990 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-02-10 | 3539 SW CORPORATE PARKWAY, PALM CITY, FL 34990 | No data |
| CHANGE OF MAILING ADDRESS | 2011-02-10 | 3539 SW CORPORATE PARKWAY, PALM CITY, FL 34990 | No data |
| Name | Date |
|---|---|
| Amendment | 2024-08-23 |
| ANNUAL REPORT | 2024-03-28 |
| ANNUAL REPORT | 2023-03-28 |
| ANNUAL REPORT | 2022-04-07 |
| ANNUAL REPORT | 2021-03-02 |
| ANNUAL REPORT | 2020-03-23 |
| ANNUAL REPORT | 2019-04-05 |
| ANNUAL REPORT | 2018-03-12 |
| ANNUAL REPORT | 2017-02-10 |
| ANNUAL REPORT | 2016-02-29 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
