| Entity Name: | JANET S MOULTON, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 15 Aug 2006 (18 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year ago) |
| Document Number: | P06000106808 |
| FEI/EIN Number | 582315364 |
| Address: | 340 16th Ave. North, Jacksonville Beach, FL, 32250, US |
| Mail Address: | 340 16th Ave. North, Jacksonville Beach, FL, 32250, US |
| ZIP code: | 32250 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1104867670 | 2006-06-08 | 2022-10-25 | 340 16TH AVE N, STE B, JACKSONVILLE BEACH, FL, 322504819, US | 340 16TH AVE N, STE B, JACKSONVILLE BEACH, FL, 322504819, US | |||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 904-249-8893 |
| Fax | 9043720496 |
Authorized person
| Name | JANET S MOULTON |
| Role | OWNER |
| Phone | 9042498893 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| Is Primary | No |
| Taxonomy Code | 225X00000X - Occupational Therapist |
| Is Primary | No |
| Taxonomy Code | 235Z00000X - Speech-Language Pathologist |
| License Number | SA4951 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 235Z00000X - Speech-Language Pathologist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 884273600 |
| State | FL |
| Issuer | BC/BS |
| Number | S1828 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MOULTON JANET S | Agent | 340 16th Ave. North, Jacksonville Beach, FL, 32250 |
| Name | Role | Address |
|---|---|---|
| MOULTON JANET S | President | 105 Oyster Bay Way, Ponte Vedra, FL, 32081 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000065244 | PEDIATRIC THERAPY ASSOCIATES | EXPIRED | 2019-06-06 | 2024-12-31 | No data | 235 9TH AVE. NORTH, JACKSONVILLE BEACH, FL, 32250 |
| G19000057259 | RX STAT | EXPIRED | 2019-05-13 | 2024-12-31 | No data | 105 OYSTER BAY WAY, PONTE VEDRA, FL, 32081 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-05-04 | 340 16th Ave. North, Suite B, Jacksonville Beach, FL 32250 | No data |
| CHANGE OF MAILING ADDRESS | 2020-05-04 | 340 16th Ave. North, Suite B, Jacksonville Beach, FL 32250 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-05-04 | 340 16th Ave. North, Suite B, Jacksonville Beach, FL 32250 | No data |
| REINSTATEMENT | 2010-08-08 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2022-02-02 |
| ANNUAL REPORT | 2021-04-26 |
| ANNUAL REPORT | 2020-05-04 |
| ANNUAL REPORT | 2019-04-26 |
| ANNUAL REPORT | 2018-03-26 |
| ANNUAL REPORT | 2017-01-10 |
| ANNUAL REPORT | 2016-03-04 |
| ANNUAL REPORT | 2015-01-09 |
| ANNUAL REPORT | 2014-04-04 |
| ANNUAL REPORT | 2013-04-10 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
