| Entity Name: | SOUTHERN THERAPIES OF NORTH FLORIDA, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 10 Feb 1997 (28 years ago) |
| Document Number: | P97000012943 |
| FEI/EIN Number | 59-3434172 |
| Mail Address: | 6 MILTON ST, ST AUGUSTINE, FL 32084 |
| Address: | 6061 ST JOHNS AVE, STE 1, PALATKA, FL 32177 |
| ZIP code: | 32177 |
| County: | Putnam |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1053305748 | 2005-09-08 | 2010-08-12 | 6050 SAINT JOHNS AVE, SUITE 1, PALATKA, FL, 321773895, US | 6050 SAINT JOHNS AVE, SUITE 1, PALATKA, FL, 321773895, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 386-312-0022 |
| Fax | 3863120535 |
Authorized person
| Name | AMANDA BENNETT |
| Role | BILLING AGENT |
| Phone | 3863120022 |
Taxonomy
| Taxonomy Code | 261QR0401X - Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Is Primary | Yes |
| Taxonomy Code | 376J00000X - Homemaker |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 6762204-00 |
| State | FL |
| Issuer | MEDICAID |
| Number | 884914500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PIERCE, THOMAS DM.S.CAP | Agent | 6 MILTON STREET, ST. AUGUSTINE, FL 32084-2114 |
| Name | Role | Address |
|---|---|---|
| PIERCE, THOMAS DM.S. | Director | 6 MILTON STREET, SAINT AUGUSTINE, FL 32084-2114 |
| Name | Role | Address |
|---|---|---|
| PIERCE, THOMAS DM.S. | President | 6 MILTON STREET, SAINT AUGUSTINE, FL 32084-2114 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2021-03-25 | 6061 ST JOHNS AVE, STE 1, PALATKA, FL 32177 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-01-20 | 6061 ST JOHNS AVE, STE 1, PALATKA, FL 32177 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2004-02-11 | 6 MILTON STREET, ST. AUGUSTINE, FL 32084-2114 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-03-29 |
| ANNUAL REPORT | 2022-04-11 |
| ANNUAL REPORT | 2021-03-25 |
| ANNUAL REPORT | 2020-03-30 |
| ANNUAL REPORT | 2019-04-07 |
| ANNUAL REPORT | 2018-01-20 |
| ANNUAL REPORT | 2017-02-07 |
| ANNUAL REPORT | 2016-04-30 |
| ANNUAL REPORT | 2015-04-28 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
