| Entity Name: | ACTIVA, LC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 16 Jan 2004 (21 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 19 Dec 2011 (13 years ago) |
| Document Number: | L04000004375 |
| FEI/EIN Number | 562428650 |
| Address: | 14100 SW 37th Court, Davie, FL, 33330, US |
| Mail Address: | 14100 SW 37th Court, Davie, FL, 33330, US |
| ZIP code: | 33330 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1245234848 | 2005-06-10 | 2010-04-02 | 9720 STIRLING RD, SUITE 104, COOPER CITY, FL, 330248014, US | 9720 STIRLING RD, SUITE 104, COOPER CITY, FL, 330248014, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 954-374-0160 |
| Fax | 9543740163 |
Authorized person
| Name | MR. OSCAR G. FERREIRA |
| Role | ADMINISTRATIVE MANAGER |
| Phone | 9543740160 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| Is Primary | Yes |
| Taxonomy Code | 2251G0304X - Geriatric Physical Therapist |
| Is Primary | No |
| Taxonomy Code | 2251X0800X - Orthopedic Physical Therapist |
| Is Primary | No |
| Taxonomy Code | 225200000X - Physical Therapy Assistant |
| Is Primary | No |
| Taxonomy Code | 225X00000X - Occupational Therapist |
| Is Primary | No |
| Taxonomy Code | 225XG0600X - Gerontology Occupational Therapist |
| Is Primary | No |
| Taxonomy Code | 225XL0004X - Low Vision Occupational Therapist |
| Is Primary | No |
| Taxonomy Code | 225XP0019X - Physical Rehabilitation Occupational Therapist |
| Is Primary | No |
| Taxonomy Code | 225XP0200X - Pediatric Occupational Therapist |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 686623996 |
| State | FL |
| Issuer | MEDICAID |
| Number | 889541400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FERREIRA OSCAR G | Agent | 14100 SW 37TH COURT, DAVIE, FL, 33330 |
| Name | Role | Address |
|---|---|---|
| APONTE MARIELA | Manager | 14100 SW 37TH COURT, DAVIE, FL, 33330 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-18 | 14100 SW 37th Court, Davie, FL 33330 | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-18 | 14100 SW 37th Court, Davie, FL 33330 | No data |
| REINSTATEMENT | 2011-12-19 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2008-06-05 | 14100 SW 37TH COURT, DAVIE, FL 33330 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-07 |
| ANNUAL REPORT | 2023-04-18 |
| ANNUAL REPORT | 2022-02-15 |
| ANNUAL REPORT | 2021-04-12 |
| ANNUAL REPORT | 2020-05-29 |
| ANNUAL REPORT | 2019-04-02 |
| ANNUAL REPORT | 2018-04-02 |
| ANNUAL REPORT | 2017-03-17 |
| ANNUAL REPORT | 2016-04-01 |
| ANNUAL REPORT | 2015-04-21 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
