| Entity Name: | DEBORAH JACKSON THERAPY ASSOCIATES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 16 Mar 2012 (13 years ago) |
| Date of dissolution: | 24 Sep 2021 (3 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2021 (3 years ago) |
| Document Number: | P12000026610 |
| FEI/EIN Number | 45-4822169 |
| Address: | 320 Point Pleasant Dr, St Augustine, FL 32086 |
| Mail Address: | PO Box 840229, Saint Augustine, FL 32080-0229 |
| ZIP code: | 32086 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1497015598 | 2012-05-22 | 2012-06-28 | 319 W TOWN PL, SUITE 5, ST AUGUSTINE, FL, 320923101, US | 319 W TOWN PL, SUITE 5, ST AUGUSTINE, FL, 320923101, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 904-342-5262 |
| Fax | 9042173580 |
Authorized person
| Name | DR. DEBORAH JACKSON |
| Role | PRESIDENT |
| Phone | 9043425262 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| License Number | PT11000 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 225100000X - Physical Therapist |
| License Number | PT20179 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 225100000X - Physical Therapist |
| License Number | PT5569 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 225100000X - Physical Therapist |
| License Number | PT7090 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 225X00000X - Occupational Therapist |
| License Number | OT9478 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 225XH1200X - Hand Occupational Therapist |
| License Number | OT7576 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 235Z00000X - Speech-Language Pathologist |
| License Number | SA299 |
| State | FL |
| Is Primary | No |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DEBORAH JACKSON THERAPY ASSOCIATES 401(K) PLAN | 2013 | 454822169 | 2014-09-26 | DEBORAH JACKSON THERAPY ASSOCIATES, INC | 2 | |||||||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2014-09-26 |
| Name of individual signing | DEBORAH JACKSON |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2014-09-26 |
| Name of individual signing | DEBORAH JACKSON |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2012-07-01 |
| Business code | 621340 |
| Sponsor’s telephone number | 9043425262 |
| Plan sponsor’s address | 319 WEST TOWN PLACE, UNIT 5, ST. AUGUSTINE, FL, 32092 |
Signature of
| Role | Plan administrator |
| Date | 2014-07-15 |
| Name of individual signing | DEBORAH JACKSON |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2014-07-15 |
| Name of individual signing | DEBORAH JACKSON |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2012-07-01 |
| Business code | 621340 |
| Sponsor’s telephone number | 9043425262 |
| Plan sponsor’s address | 319 WEST TOWN PLACE, UNIT 5, ST. AUGUSTINE, FL, 32092 |
Signature of
| Role | Plan administrator |
| Date | 2013-06-26 |
| Name of individual signing | DEBORAH JACKSON |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| JACKSON, DEBORAH A | Agent | 320 Point Pleasant Drive, Saint Augustine, FL 32086 |
| Name | Role | Address |
|---|---|---|
| JACKSON, DEBORAH A | President | 320 Point Pleasant Drive, Saint Augustine, FL 32086 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-03-05 | 320 Point Pleasant Dr, St Augustine, FL 32086 | No data |
| CHANGE OF MAILING ADDRESS | 2019-03-05 | 320 Point Pleasant Dr, St Augustine, FL 32086 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-04-09 | 320 Point Pleasant Drive, Saint Augustine, FL 32086 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2020-04-22 |
| ANNUAL REPORT | 2019-03-05 |
| ANNUAL REPORT | 2018-04-09 |
| ANNUAL REPORT | 2017-03-30 |
| ANNUAL REPORT | 2016-02-06 |
| ANNUAL REPORT | 2015-04-13 |
| ANNUAL REPORT | 2014-02-27 |
| ANNUAL REPORT | 2013-02-07 |
| Domestic Profit | 2012-03-16 |
Date of last update: 23 Jan 2025
Sources: Florida Department of State
