| Entity Name: | OPTIMAL PERFORMANCE AND PHYSICAL THERAPIES - NORTHDALE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 25 Jan 2010 (15 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 27 Nov 2017 (7 years ago) |
| Document Number: | L10000009182 |
| FEI/EIN Number | 271750663 |
| Mail Address: | 14004 Roosevelt Blvd, Suite 613, Clearwater, FL, 33762, US |
| Address: | 3903 Northdale Blvd. Suite 111W, Tampa, FL, 33624, US |
| ZIP code: | 33624 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1093399347 | 2021-05-11 | 2023-11-06 | 21756 STATE ROAD 54 STE 102, LUTZ, FL, 335492905, US | 6633 GUNN HIGHWAY, TAMPA, FL, 33625, US | |||||||||||||
|
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| Phone | +1 727-475-5540 |
Authorized person
| Name | BETH ANN PATTERSON |
| Role | PRACTICE ADMINISTRATOR |
| Phone | 7274755540 |
Taxonomy
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| STEGEMAN WILLEM | Agent | 3903 NORTHDALE BLVD, TAMPA, FL, 33624 |
| Name | Role | Address |
|---|---|---|
| STEGEMAN WILLEM | Manager | 3903 NORTHDALE BLVD, TAMPA, FL, 33624 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2023-10-16 | 3903 Northdale Blvd. Suite 111W, Tampa, FL 33624 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-09-20 | 3903 Northdale Blvd. Suite 111W, Tampa, FL 33624 | No data |
| LC STMNT OF RA/RO CHG | 2017-11-27 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-11-27 | 3903 NORTHDALE BLVD, STE 111W, TAMPA, FL 33624 | No data |
| LC AMENDMENT | 2017-08-14 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2017-08-14 | STEGEMAN, WILLEM | No data |
| LC AMENDMENT | 2012-07-02 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-01 |
| ANNUAL REPORT | 2023-01-18 |
| ANNUAL REPORT | 2022-01-20 |
| ANNUAL REPORT | 2021-01-10 |
| ANNUAL REPORT | 2020-01-19 |
| ANNUAL REPORT | 2019-01-26 |
| ANNUAL REPORT | 2018-01-14 |
| CORLCRACHG | 2017-11-27 |
| LC Amendment | 2017-08-14 |
| ANNUAL REPORT | 2017-01-10 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
