| Entity Name: | SARASOTA PHYSICAL MEDICINE INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 24 Jun 2004 (21 years ago) |
| Last Event: | NAME CHANGE AMENDMENT |
| Event Date Filed: | 09 Apr 2013 (12 years ago) |
| Document Number: | P04000096470 |
| FEI/EIN Number | 201284540 |
| Address: | 3687 WEBBER STREET, SARASOTA, FL, 34232, US |
| Mail Address: | 3687 WEBBER STREET, SARASOTA, FL, 34232, US |
| ZIP code: | 34232 |
| County: | Sarasota |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1225073315 | 2006-06-20 | 2013-05-06 | 3687 WEBBER ST, SARASOTA, FL, 342324412, US | 3687 WEBBER ST, SARASOTA, FL, 342324412, US | |||||||||||||||||||||||||||||||
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| Phone | +1 941-922-9312 |
| Fax | 9419278731 |
Authorized person
| Name | MICHELE LAMOURT |
| Role | PRESIDENT |
| Phone | 9419229312 |
Taxonomy
| Taxonomy Code | 111NI0900X - Internist Chiropractor |
| License Number | CH7627 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 74824 |
| State | FL |
| Issuer | MEDICAID |
| Number | 381346100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Lamourt Michele | Agent | 3687 Webber St., SARASOTA, FL, 34232 |
| Name | Role | Address |
|---|---|---|
| LAMOURT MICHELE | President | 3687 WEBBER STREET, SARASOTA, FL, 34232 |
| Name | Role | Address |
|---|---|---|
| HALEY JAMES E | Vice President | 3687 WEBBER STREET, SARASOTA, FL, 34232 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G09084900240 | SARASOTA PHYSICAL MEDICINE | EXPIRED | 2009-03-25 | 2014-12-31 | No data | 3687 WEBBER ST., SARASOTA, FL, 34232 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-02-07 | Lamourt, Michele | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-07 | 3687 Webber St., SARASOTA, FL 34232 | No data |
| NAME CHANGE AMENDMENT | 2013-04-09 | SARASOTA PHYSICAL MEDICINE INC | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-07 |
| ANNUAL REPORT | 2023-01-31 |
| ANNUAL REPORT | 2022-02-01 |
| ANNUAL REPORT | 2021-01-12 |
| ANNUAL REPORT | 2020-02-11 |
| ANNUAL REPORT | 2019-04-02 |
| ANNUAL REPORT | 2018-04-02 |
| ANNUAL REPORT | 2017-01-12 |
| ANNUAL REPORT | 2016-01-20 |
| ANNUAL REPORT | 2015-01-09 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
