| Entity Name: | FUNDAMENTALS PEDIATRIC THERAPY SERVICES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 17 Oct 2012 (12 years ago) |
| Document Number: | L12000132292 |
| FEI/EIN Number | 46-1208150 |
| Address: | 685 NE 179 terr, Miami, FL, 33162, US |
| Mail Address: | 685 NE 179 terr, Miami, FL, 33162, US |
| ZIP code: | 33162 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1164841607 | 2014-04-14 | 2014-04-14 | 4140 N MERIDIAN AVE, #1, MIAMI BEACH, FL, 331403321, US | 4140 N MERIDIAN AVE, #1, MIAMI BEACH, FL, 331403321, US | |||||||||||||||||||||||
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| Phone | +1 347-525-4839 |
Authorized person
| Name | TOVA FUND |
| Role | MEMBER/MANAGER |
| Phone | 3475254839 |
Taxonomy
| Taxonomy Code | 225X00000X - Occupational Therapist |
| License Number | OT13579 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 000913500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FUND TOVA | Agent | 685 NE 179 terr, Miami, FL, 33162 |
| Name | Role | Address |
|---|---|---|
| FUND TOVA | Managing Member | 685 NE 179 terr, Miami, FL, 33162 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-01-29 | 685 NE 179 terr, Miami, FL 33162 | No data |
| CHANGE OF MAILING ADDRESS | 2023-01-29 | 685 NE 179 terr, Miami, FL 33162 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-01-29 | 685 NE 179 terr, Miami, FL 33162 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-14 |
| ANNUAL REPORT | 2024-01-23 |
| ANNUAL REPORT | 2023-01-29 |
| ANNUAL REPORT | 2022-01-24 |
| ANNUAL REPORT | 2021-01-29 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-06-12 |
| ANNUAL REPORT | 2018-01-12 |
| ANNUAL REPORT | 2017-02-08 |
| ANNUAL REPORT | 2016-03-26 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
