| Entity Name: | PHYSIOCARE MEDICAL & WELLNESS CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 11 Dec 2002 (22 years ago) |
| Date of dissolution: | 22 Sep 2017 (7 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2017 (7 years ago) |
| Document Number: | P02000130606 |
| FEI/EIN Number | 61-1437137 |
| Address: | 8204 CRYSTAL CLEAR LANE, SUITE 1500, ORLANDO, FL 32809 |
| Mail Address: | P.O. BOX 771977, ORLANDO, FL 32877 |
| ZIP code: | 32809 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1467684878 | 2009-08-18 | 2009-08-18 | 8204 CRYSTAL CLEAR LN, SUITE 1500, ORLANDO, FL, 328097758, US | 8204 CRYSTAL CLEAR LN, SUITE 1500, ORLANDO, FL, 328097758, US | |||||||||||||||||||
|
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| Phone | +1 407-240-8884 |
| Fax | 4072408388 |
Authorized person
| Name | DR. FREDERIC J FREEMAN II |
| Role | MEDICAL DIRECTOR |
| Phone | 4072408884 |
Taxonomy
| Taxonomy Code | 302R00000X - Health Maintenance Organization |
| License Number | HCC5023 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| JOHN, ARBOLEDA | Agent | 8204 CRYSTAL CLEAR LN., SUITE 1500, ORLANDO, FL 32809 |
| Name | Role | Address |
|---|---|---|
| ARBOLEDA, JOHN | Director | 8204 CRYSTAL CLEAR LANE SUITE 1500, ORLANDO, FL 32809 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-05-20 | 8204 CRYSTAL CLEAR LN., SUITE 1500, ORLANDO, FL 32809 | No data |
| CHANGE OF MAILING ADDRESS | 2014-03-06 | 8204 CRYSTAL CLEAR LANE, SUITE 1500, ORLANDO, FL 32809 | No data |
| NAME CHANGE AMENDMENT | 2005-09-12 | PHYSIOCARE MEDICAL & WELLNESS CENTER, INC. | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2005-09-12 | 8204 CRYSTAL CLEAR LANE, SUITE 1500, ORLANDO, FL 32809 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2016-03-03 |
| ANNUAL REPORT | 2015-05-20 |
| ANNUAL REPORT | 2014-03-06 |
| ANNUAL REPORT | 2013-01-02 |
| ANNUAL REPORT | 2012-01-03 |
| ANNUAL REPORT | 2011-01-26 |
| ANNUAL REPORT | 2010-02-12 |
| ANNUAL REPORT | 2009-01-21 |
| ANNUAL REPORT | 2008-01-11 |
| ANNUAL REPORT | 2007-04-25 |
Date of last update: 30 Jan 2025
Sources: Florida Department of State
