| Entity Name: | PHYSICAL HEALTHCARE OF JACKSONVILLE, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
PHYSICAL HEALTHCARE OF JACKSONVILLE, 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: | 28 Dec 2012 (12 years ago) |
| Last Event: | CORPORATE MERGER |
| Event Date Filed: | 19 Oct 2018 (7 years ago) |
| Document Number: | P12000104228 |
| FEI/EIN Number |
461666015
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 12620 BEACH BLVD, Suite 6, JACKSONVILLE, FL, 32246, US |
| Mail Address: | 12620 BEACH BLVD, Suite 6, JACKSONVILLE, FL, 32246, US |
| ZIP code: | 32246 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1760722011 | 2013-02-25 | 2017-04-18 | 12620 BEACH BLVD, SUITE 6, JACKSONVILLE, FL, 322467131, US | 12620 BEACH BLVD, SUITE 6, JACKSONVILLE, FL, 322467131, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 904-645-0777 |
| Fax | 9046453483 |
Authorized person
| Name | MARK A PIERCE |
| Role | CLINIC DIRECTOR |
| Phone | 9046450777 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH6451 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH6588 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH4435 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME55161 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| License Number | ME0060908 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 225100000X - Physical Therapist |
| License Number | PT30658 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | ME0060908 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | ME55161 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 363AM0700X - Medical Physician Assistant |
| License Number | PA9106788 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| License Number | ARNP 770742 |
| State | FL |
| Is Primary | No |
| 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 |
| 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 |
| 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 | - | - |
| 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 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 7634027004 | 2020-04-07 | 0491 | PPP | 12620 BEACH BLVD, Suite 6, JACKSONVILLE, FL, 32246-4152 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 7357738405 | 2021-02-11 | 0491 | PPS | 12620 Beach Blvd Ste 6, Jacksonville, FL, 32246-4152 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 03 May 2025
Sources: Florida Department of State
