| Entity Name: | AZ PT INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 22 Sep 2015 (9 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 12 Apr 2020 (5 years ago) |
| Document Number: | P15000077932 |
| FEI/EIN Number | 47-5141959 |
| Address: | 5525 SW Woodham Street, Palm city, FL, 34990, US |
| Mail Address: | 5525 SW Woodham Street, Palm city, FL, 34990, US |
| ZIP code: | 34990 |
| County: | Martin |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508220203 | 2016-04-08 | 2016-09-08 | 10570 S US HIGHWAY 1, SUITE 101, PORT ST LUCIE, FL, 349525606, US | 10570 S US HIGHWAY 1, SUITE 101, PORT ST LUCIE, FL, 349525606, US | |||||||||||||||||||||||||||
|
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| Phone | +1 771-212-7436 |
| Fax | 7722127482 |
| Phone | +1 772-212-7436 |
Authorized person
| Name | NICOLE J WOJNO |
| Role | DIRECTOR/PHYSICAL THERAPIST |
| Phone | 7862583763 |
Taxonomy
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| License Number | 22612 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 006732700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| WOJNO NICOLE J | Agent | 5525 SW Woodham Street, Palm city, FL, 34990 |
| Name | Role | Address |
|---|---|---|
| WOJNO NICOLE J | President | 5525 SW Woodham Street, Palm city, FL, 34990 |
| Name | Role | Address |
|---|---|---|
| WOJNO NICOLE J | Director | 5525 SW Woodham Street, Palm city, FL, 34990 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-04 | 5525 SW Woodham Street, Palm city, FL 34990 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-04 | 5525 SW Woodham Street, Palm city, FL 34990 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-04 | 5525 SW Woodham Street, Palm city, FL 34990 | No data |
| REINSTATEMENT | 2020-04-12 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2020-04-12 | WOJNO, NICOLE J | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J19000502235 | TERMINATED | 1000000834414 | MARTIN | 2019-07-19 | 2029-07-24 | $ 687.17 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, FORT PIERCE SERVICE CENTER, 337 N US HIGHWAY 1 STE 207-B, FORT PIERCE FL349504255 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-04 |
| ANNUAL REPORT | 2023-03-22 |
| ANNUAL REPORT | 2022-03-11 |
| ANNUAL REPORT | 2021-01-12 |
| REINSTATEMENT | 2020-04-12 |
| ANNUAL REPORT | 2017-04-25 |
| ANNUAL REPORT | 2016-07-07 |
| Domestic Profit | 2015-09-22 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
