| Entity Name: | PEDIATRIC THERAPY WORKS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 19 Aug 2003 (21 years ago) |
| Document Number: | P03000091936 |
| FEI/EIN Number | 562396758 |
| Address: | 2753 SR 580, STE 111, CLEARWATER, FL, 33761, US |
| Mail Address: | 2753 SR 580, STE 111, CLEARWATER, FL, 33761, US |
| ZIP code: | 33761 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1730389248 | 2007-07-23 | 2022-03-11 | 2753 SR 580 STE 111, CLEARWATER, FL, 337613352, US | 2753 SR 580 STE 111, CLEARWATER, FL, 337613352, US | |||||||||||||||||||||||||||||
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| Phone | +1 727-724-5437 |
| Fax | 8134352125 |
Authorized person
| Name | MRS. AMY L PERRY |
| Role | OWNER |
| Phone | 7277245437 |
Taxonomy
| Taxonomy Code | 261QR0401X - Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Is Primary | Yes |
| Taxonomy Code | 320900000X - Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility |
| License Number | OT 9659 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 891770100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PERRY AMY | Agent | 2753 SR 580, CLEARWATER, FL, 33761 |
| Name | Role | Address |
|---|---|---|
| PERRY AMY | President | 386 Sheffield Circle West, Palm Harbor, FL, 34683 |
| PERRY WILLIAM | President | 386 Sheffield Circle West, Palm Harbor, FL, 34683 |
| Name | Role | Address |
|---|---|---|
| PERRY WILLIAM | Vice President | 386 Sheffield Circle West, Palm Harbor, FL, 34683 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G06116900040 | FOUNDATIONS THERAPY | ACTIVE | 2006-04-25 | 2026-12-31 | No data | 2753 SR 580, SUITE 111, CLEARWATER, FL, 33761 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2016-03-18 | 2753 SR 580, STE 111, CLEARWATER, FL 33761 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-03-20 | 2753 SR 580, STE 111, CLEARWATER, FL 33761 | No data |
| CHANGE OF MAILING ADDRESS | 2015-03-20 | 2753 SR 580, STE 111, CLEARWATER, FL 33761 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-01 |
| ANNUAL REPORT | 2023-03-06 |
| ANNUAL REPORT | 2022-01-27 |
| ANNUAL REPORT | 2021-02-04 |
| ANNUAL REPORT | 2020-01-20 |
| ANNUAL REPORT | 2019-02-08 |
| ANNUAL REPORT | 2018-01-15 |
| ANNUAL REPORT | 2017-02-09 |
| ANNUAL REPORT | 2016-03-18 |
| ANNUAL REPORT | 2015-03-20 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
