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  5. EXTREME SPORTS MEDICINE & REHABILITATION INC.

EXTREME SPORTS MEDICINE & REHABILITATION INC.

Company Details

Entity Name: EXTREME SPORTS MEDICINE & REHABILITATION INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 04 Jun 2013 (12 years ago)
Last Event: AMENDMENT
Event Date Filed: 17 Nov 2016 (8 years ago)
Document Number: P13000048195
FEI/EIN Number 46-2846802
Address: 14125 NW 80TH AVENUE SUITE 203, MIAMI LAKES, FL, 33016, US
Mail Address: 4393 SW 130TH AVE, DAVIE, FL, 33330, US
ZIP code: 33016
County: Miami-Dade
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1215377569 2013-07-01 2019-08-14 4393 SW 130TH AVE, DAVIE, FL, 333304730, US 14125 NW 80TH AVE STE 203, MIAMI LAKES, FL, 330162351, US

Contacts
Phone +1 954-665-7326
Fax 3058469653
Phone +1 305-381-5357

Authorized person
Name MR. SEAN WILLIAMS
Role PRESIDENT
Phone 9546657326

Taxonomy
Taxonomy Code 225100000X - Physical Therapist
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EXTREME SPORTS MEDICINE & REHABILITATION INC. 401(K) PLAN 2023 462846802 2024-07-19 EXTREME SPORTS MEDICINE & REHABILITATION INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621399
Sponsor’s telephone number 3053815357
Plan sponsor’s address 14125 NW 80TH AVENUE, SUITE 203, MIAMI, FL, 33016
EXTREME SPORTS MEDICINE & REHABILITATION INC. 401(K) PLAN 2022 462846802 2023-05-01 EXTREME SPORTS MEDICINE & REHABILITATION INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621399
Sponsor’s telephone number 3053815357
Plan sponsor’s address 14125 NW 80TH AVENUE, SUITE 203, MIAMI, FL, 33016
EXTREME SPORTS MEDICINE & REHABILITATION INC. 401(K) PLAN 2021 462846802 2022-04-13 EXTREME SPORTS MEDICINE & REHABILITATION INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621399
Sponsor’s telephone number 3053815357
Plan sponsor’s address 14125 NW 80TH AVENUE, SUITE 203, MIAMI, FL, 33016
EXTREME SPORTS MEDICINE & REHABILITATION INC. 401(K) PLAN 2020 462846802 2021-04-16 EXTREME SPORTS MEDICINE & REHABILITATION INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621399
Sponsor’s telephone number 3053815357
Plan sponsor’s address 14125 NW 80TH AVENUE, SUITE 203, MIAMI, FL, 33016
EXTREME SPORTS MEDICINE & REHABILITATION INC. 401(K) PLAN 2019 462846802 2020-02-26 EXTREME SPORTS MEDICINE & REHABILITATION INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621399
Sponsor’s telephone number 3053815357
Plan sponsor’s address 14125 NW 80TH AVENUE, SUITE 203, MIAMI, FL, 33016
EXTREME SPORTS MEDICINE & REHABILITATION INC. 401(K) PLAN 2018 462846802 2019-04-08 EXTREME SPORTS MEDICINE & REHABILITATION INC. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621399
Sponsor’s telephone number 3053815357
Plan sponsor’s address 14125 NW 80TH AVENUE, SUITE 203, MIAMI, FL, 33016

Agent

Name Role Address
WILLIAMS SEAN A Agent 4393 SW 130TH AVE, DAVIE, FL, 33330

President

Name Role Address
WILLIAMS SEAN A President 4393 SW 130TH AVE, DAVIE, FL, 33330

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G14000021520 SEAN WILLIAMS ACTIVE 2014-02-28 2029-12-31 No data 14125 NW 80TH AVE, SUITE 203, MIAMI LAKES, FL, 33016

Events

Event Type Filed Date Value Description
AMENDMENT 2016-11-17 No data No data
CHANGE OF PRINCIPAL ADDRESS 2016-11-17 14125 NW 80TH AVENUE SUITE 203, MIAMI LAKES, FL 33016 No data
AMENDMENT 2015-04-27 No data No data

Documents

Name Date
ANNUAL REPORT 2024-01-19
ANNUAL REPORT 2023-01-19
ANNUAL REPORT 2022-01-25
ANNUAL REPORT 2021-01-13
ANNUAL REPORT 2020-01-23
ANNUAL REPORT 2019-01-27
ANNUAL REPORT 2018-01-17
ANNUAL REPORT 2017-01-09
Amendment 2016-11-17
ANNUAL REPORT 2016-01-27

Related by officers

WILLIAMS SEAN A

WILLIAMS PHOTOGRAPHY & EVENTS, LLC ONE COAST CONSTRUCTION LLC HIGH CANDELA LLC LEGACY OAKS RANCH LLC SAW CONTRACTING, INC. UW 9055, LLC HIGH SPEED HOBBIES, INC.

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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