| Entity Name: | PROGRESSIVE PHYSICAL THERAPY SERVICE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 17 Nov 1999 (25 years ago) |
| Document Number: | P99000101655 |
| FEI/EIN Number | 650970368 |
| Address: | 17751 Murdock Circle, Port Charlotte, FL, 33948, US |
| Mail Address: | 20412 WINGATE AVE., PORT CHARLOTTE, FL, 33954 |
| ZIP code: | 33948 |
| County: | Charlotte |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043261233 | 2006-05-13 | 2020-08-22 | 17751 MURDOCK CIR, PORT CHARLOTTE, FL, 339481034, US | 17751 MURDOCK CIR, PORT CHARLOTTE, FL, 339481034, US | |||||||||||||||||||||||||
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| Phone | +1 941-743-8700 |
| Fax | 9417438850 |
Authorized person
| Name | MR. WAYNE GOFFIN |
| Role | PRESIDENT |
| Phone | 9417438700 |
Taxonomy
| Taxonomy Code | 2251X0800X - Orthopedic Physical Therapist |
| License Number | 7920 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BC/BS |
| Number | Y911K |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GOFFIN WAYNE A | Agent | 20412 WINGATE AVE., PT. CHARLOTTE, FL, 33954 |
| Name | Role | Address |
|---|---|---|
| GOFFIN WAYNE A | Director | 20412 WINGATE AVE., PT. CHARLOTTE, FL, 33954 |
| GOFFIN BARBARA | Director | 20412 WINGATE AVE., PT. CHARLOTTE, FL, 33954 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000042856 | FYZICAL FITNESS | EXPIRED | 2018-04-03 | 2023-12-31 | No data | 17751 MURDOCK CIRCLE, PORT CHARLOTTE, FL, 33948 |
| G15000048146 | FYZICAL FITNESS | EXPIRED | 2015-05-14 | 2020-12-31 | No data | 17751 MURDOCK CIRCLE, PORT CHARLOTTE, FL, 33948 |
| G15000048142 | PROGRESSIVE HEALTH CLUB | EXPIRED | 2015-05-14 | 2020-12-31 | No data | 17751 MURDOCK CIRCLE, PORT CHARLOTTE, FL, 33948 |
| G15000038261 | FYZICAL THERAPY & BALANCE CENTERS | ACTIVE | 2015-04-15 | 2026-12-31 | No data | 20412 WINGATE AVE, PORT CHARLOTTE, FL, 33954 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-07-30 | 17751 Murdock Circle, Port Charlotte, FL 33948 | No data |
| CHANGE OF MAILING ADDRESS | 2010-04-02 | 17751 Murdock Circle, Port Charlotte, FL 33948 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-04-02 | 20412 WINGATE AVE., PT. CHARLOTTE, FL 33954 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-02 |
| ANNUAL REPORT | 2023-04-02 |
| ANNUAL REPORT | 2022-07-30 |
| ANNUAL REPORT | 2021-02-09 |
| ANNUAL REPORT | 2020-06-15 |
| ANNUAL REPORT | 2019-04-05 |
| ANNUAL REPORT | 2018-01-19 |
| ANNUAL REPORT | 2017-01-11 |
| ANNUAL REPORT | 2016-03-03 |
| ANNUAL REPORT | 2015-02-17 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
