| Entity Name: | AMPUTEE CLINIC, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
AMPUTEE CLINIC, INC is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 01 Mar 2012 (13 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 05 Mar 2024 (a year ago) |
| Document Number: | P12000021025 |
| FEI/EIN Number |
45-4672954
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 7051 CYPRESS TERRACE #108, FORT MYERS, FL, 33907 |
| Mail Address: | 7051 CYPRESS TERRACE #108, FORT MYERS, FL, 33907 |
| ZIP code: | 33907 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1295730216 | 2005-06-16 | 2012-08-30 | 7051 CYPRESS TER, #108, FORT MYERS, FL, 339078822, US | 7051 CYPRESS TER, #108, FORT MYERS, FL, 339078822, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 239-437-4010 |
| Fax | 2394374097 |
Authorized person
| Name | MR. MARCUM R RANDALL |
| Role | PRESIDENT PT CP LPO |
| Phone | 2394374010 |
Taxonomy
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 335E00000X - Prosthetic/Orthotic Supplier |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 009939684 |
| State | AL |
| Issuer | NORTHWOOD (BC/BS MI DME) |
| Number | 81750 |
| State | MI |
| Issuer | TVA |
| Number | 204925600 |
| State | TN |
| Issuer | NORTHWOOD |
| Number | 8150 |
| State | MI |
| Issuer | MEDICAID |
| Number | 1454256 |
| State | TN |
| Issuer | GEORGIA HEALTH PARTNERSHI |
| Number | 52895744 001 |
| State | GA |
| Issuer | MEDICAID |
| Number | 1295730216 |
| State | VA |
| Issuer | MEDICAID |
| Number | 000914064A |
| State | GA |
| Issuer | BC/BS OF TN |
| Number | 004016999 |
| State | TN |
| Issuer | PHP, CARITEN, PHP TENNCAR |
| Number | 13125 |
| State | TN |
| Issuer | BC/BS TN |
| Number | 4016999 |
| State | TN |
| Name | Role | Address |
|---|---|---|
| RANDALL MARCUM R | President | 7051 CYPRESS TERRACE #108, FORT MYERS, FL, 33907 |
| RANDALL MARCUM R | Treasurer | 7051 CYPRESS TERRACE #108, FORT MYERS, FL, 33907 |
| HEAD WILLIAM CPA | Agent | 1845 SE 4 AVENUE, FT. LAUDERDALE, FL, 33316 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G14000063627 | ALL AMERICAN AMPUTEE | EXPIRED | 2014-06-20 | 2019-12-31 | - | 7051 CYPRESS TERRACE #108, FORT MYERS, FL, 33907 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2024-03-05 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | - | - |
| REGISTERED AGENT ADDRESS CHANGED | 2016-04-15 | 1845 SE 4 AVENUE, FT. LAUDERDALE, FL 33316 | - |
| REGISTERED AGENT NAME CHANGED | 2013-04-25 | HEAD, WILLIAM, CPA | - |
| CHANGE OF PRINCIPAL ADDRESS | 2012-07-19 | 7051 CYPRESS TERRACE #108, FORT MYERS, FL 33907 | - |
| CHANGE OF MAILING ADDRESS | 2012-07-19 | 7051 CYPRESS TERRACE #108, FORT MYERS, FL 33907 | - |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J13001490615 | TERMINATED | 1000000536198 | LEE | 2013-09-17 | 2033-10-03 | $ 300.00 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, FORT MYERS SERVICE CENTER, 2295 VICTORIA AVE STE 270, FORT MYERS FL339013871 |
| Name | Date |
|---|---|
| REINSTATEMENT | 2024-03-05 |
| ANNUAL REPORT | 2022-04-22 |
| ANNUAL REPORT | 2021-03-22 |
| ANNUAL REPORT | 2020-01-23 |
| ANNUAL REPORT | 2019-02-08 |
| ANNUAL REPORT | 2018-04-17 |
| ANNUAL REPORT | 2017-04-25 |
| ANNUAL REPORT | 2016-04-15 |
| ANNUAL REPORT | 2015-04-21 |
| ANNUAL REPORT | 2014-04-06 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 6812138509 | 2021-03-04 | 0455 | PPP | 7051 Cypress Ter Ste 108, Fort Myers, FL, 33907-8801 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Apr 2025
Sources: Florida Department of State
