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Coastal Physical Medicine, Inc.

Details

Name: Coastal Physical Medicine, Inc.
Jurisdiction: Alabama
Legal type: Domestic Corporation
Status: Dissolved
Date of registration: 04 Jun 2012 (12 years ago) (Companies founded in June 2012)
Date of dissolution: 17 Mar 2014
Entity Number: 000-060-923
Register Number: 000060923
Historical Names: Back on Track Physical Medicine, Inc.
ZIP code: 36535 (Companies in Baldwin, 36535)
County: Baldwin
Place of Formation: Baldwin County
Principal Address: 1600 N MCKENZIE STFOLEY, AL 36535
Authorized Capital: 1000 @ $.01 PV

Activities PRACTICE OF ANY BRANCH OF THE HEALING ARTS

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1407290695 2013-04-18 2013-08-14 1600 N MCKENZIE ST, FOLEY, AL, 365352248, US 1600 N MCKENZIE ST, FOLEY, AL, 365352248, US

Contacts

Phone +1 251-955-2225
Fax 2519801945

Authorized person

Name DR. RICHARD RIZZUTO
Role PRESIDENT
Phone 2519552225

Taxonomy

Taxonomy Code 207Q00000X - Family Medicine Physician
License Number 24538
State AL
Is Primary Yes

Agent

Name Role Address
RIZZUTO, RICHARD Agent 1600 N MCKENZIE STFOLEY, AL 36535

Director

Name Role Address
RIZZUTO, RICHARD Director 1600 N MCKENZIE STFOLEY, AL 36535

Incorporator

Name Role Address
MEYER, ALBERT R Incorporator 1340 PIAZZA PITTIBOYNTON BEACH, FL 33426

Events

Event Date Event Type Old Value New Value
2013-04-18 Name Change Back on Track Physical Medicine, Inc. Coastal Physical Medicine, Inc.

Date of last update: 31 Jul 2024

Sources: Alabama Secretary of State