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PHYSICAL HEALTHCARE OF JACKSONVILLE, INC - Florida Company Profile

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Company Details

Entity Name: PHYSICAL HEALTHCARE OF JACKSONVILLE, INC
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 28 Dec 2012 (13 years ago)
Last Event: CORPORATE MERGER
Event Date Filed: 19 Oct 2018 (7 years ago)
Document Number: P12000104228
FEI/EIN Number 461666015
Address: 12620 BEACH BLVD, Suite 6, JACKSONVILLE, FL, 32246, US
Mail Address: 12620 BEACH BLVD, Suite 6, JACKSONVILLE, FL, 32246, US
ZIP code: 32246
City: Jacksonville
County: Duval
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
PIERCE MARK ASR President 12620 BEACH BLVD, JACKSONVILLE, FL, 32246
Pierce Elaine C Secretary 12620 BEACH BLVD, JACKSONVILLE, FL, 32246
Farah Law Agent 6550 ST. AUGUSTINE ROAD, Jacksonville, FL, 32217

Unique Entity ID

CAGE Code:
8BMW6
UEI Expiration Date:
2021-02-20

Business Information

Activation Date:
2020-02-21
Initial Registration Date:
2019-05-20

National Provider Identifier

NPI Number:
1760722011

Authorized Person:

Name:
MARK A PIERCE
Role:
CLINIC DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
111N00000X - Chiropractor
Is Primary:
No
Selected Taxonomy:
111N00000X - Chiropractor
Is Primary:
No
Selected Taxonomy:
111N00000X - Chiropractor
Is Primary:
No
Selected Taxonomy:
208100000X - Physical Medicine & Rehabilitation Physician
Is Primary:
No
Selected Taxonomy:
225100000X - Physical Therapist
Is Primary:
No

Contacts:

Fax:
9046453483

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G20000154949 ANODYNE PAIN & WELLNESS OF JACKSONVILLE ACTIVE 2020-12-07 2025-12-31 - 12620 BEACH BLVD, STE 6, JACKSONVILLE, FL, 32246
G14000099332 FIT RX EXPIRED 2014-09-30 2019-12-31 - 12620-7 BEACH BLVD, JACKSONVILLE, FL, 32246
G14000092922 FIT LIFE AT PHYSICAL HEALTHCARE OF JACKSONVILLE, INC EXPIRED 2014-09-11 2019-12-31 - 12620-6 BEACH BLVD, JACKSONVILLE, FL, 32246
G14000051697 NEUROPATHY TREATMENT CENTER AT PHYSICAL HEALTHCARE OF JACKSONVILLE INC EXPIRED 2014-05-28 2019-12-31 - 12620-6 BEACH BLVD, JACKSONVILLE, FL, 32246

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2023-08-23 12620 BEACH BLVD, Suite 6, JACKSONVILLE, FL 32246 -
REGISTERED AGENT ADDRESS CHANGED 2023-08-23 6550 ST. AUGUSTINE ROAD, Suite 103, Jacksonville, FL 32217 -
REGISTERED AGENT NAME CHANGED 2023-08-23 Farah Law -
CHANGE OF PRINCIPAL ADDRESS 2021-03-04 12620 BEACH BLVD, Suite 6, JACKSONVILLE, FL 32246 -
MERGER 2018-10-19 - CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 1. MERGER NUMBER 900000186199
REINSTATEMENT 2013-12-09 - -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2013-09-27 - -

Documents

Name Date
ANNUAL REPORT 2024-04-04
AMENDED ANNUAL REPORT 2023-08-23
ANNUAL REPORT 2023-05-24
ANNUAL REPORT 2022-02-21
ANNUAL REPORT 2021-05-19
AMENDED ANNUAL REPORT 2020-12-04
ANNUAL REPORT 2020-05-07
ANNUAL REPORT 2019-03-26
Merger 2018-10-19
ANNUAL REPORT 2018-04-25

USAspending Awards / Financial Assistance

Date:
2021-02-11
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
138387.50
Total Face Value Of Loan:
138387.50
Date:
2020-04-08
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
138300.00
Total Face Value Of Loan:
138300.00

Paycheck Protection Program

Jobs Reported:
13
Initial Approval Amount:
$138,387.5
Date Approved:
2021-02-11
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$138,387.5
Race:
Unanswered
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Veteran
Forgiveness Amount:
$140,207.39
Servicing Lender:
CIBC Bank USA
Use of Proceeds:
Payroll: $138,386.5
Jobs Reported:
13
Initial Approval Amount:
$138,300
Date Approved:
2020-04-07
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$138,300
Race:
Unanswered
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Veteran
Forgiveness Amount:
$139,713.31
Servicing Lender:
CIBC Bank USA
Use of Proceeds:
Payroll: $138,300

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Date of last update: 03 Jul 2025

Sources: Florida Department of State