| Entity Name: | FUNCTIONALLY LIMITLESS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 08 Sep 2016 (8 years ago) |
| Last Event: | LC AMENDMENT AND NAME CHANGE |
| Event Date Filed: | 26 Feb 2018 (7 years ago) |
| Document Number: | L16000167726 |
| FEI/EIN Number | 81-3806485 |
| Address: | 2425 N Courtenay Pkwy, Ste 103, Merritt Island, FL, 32953, US |
| Mail Address: | 2425 N Courtenay Pkwy, Ste 103, Merritt Island, FL, 32953, US |
| ZIP code: | 32953 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1689166571 | 2018-06-05 | 2024-02-02 | 2585 LYNWOOD PL, MERRITT ISLAND, FL, 329534163, US | 2425 N COURTENAY PKWY STE 103, MERRITT ISLAND, FL, 329534181, US | |||||||||||||||||||||||||||
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| Phone | +1 954-325-9395 |
| Fax | 8442109901 |
| Phone | +1 321-795-4213 |
Authorized person
| Name | DR. TRAVIS D BOERSMA |
| Role | OWNER |
| Phone | 9543259395 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| License Number | PT26481 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 726167 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BOERSMA TRAVIS DDR | Agent | 2585 LYNWOOD PLACE, MERRITT ISLAND, FL, 32953 |
| Name | Role | Address |
|---|---|---|
| BOERSMA TRAVIS DDR | President | 2585 LYNWOOD PLACE, MERRITT ISLAND, FL, 32953 |
| Name | Role | Address |
|---|---|---|
| DAVEY BRANDON | Authorized Member | 2990 MANITOBA LN, MELBOURNE, FL, 32935 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2023-03-07 | 2425 N Courtenay Pkwy, Ste 103, Merritt Island, FL 32953 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-02-18 | 2425 N Courtenay Pkwy, Ste 103, Merritt Island, FL 32953 | No data |
| LC AMENDMENT AND NAME CHANGE | 2018-02-26 | FUNCTIONALLY LIMITLESS, LLC | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-04-23 | 2585 LYNWOOD PLACE, MERRITT ISLAND, FL 32953 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-30 |
| ANNUAL REPORT | 2023-03-07 |
| ANNUAL REPORT | 2022-03-09 |
| ANNUAL REPORT | 2021-02-01 |
| ANNUAL REPORT | 2020-01-21 |
| ANNUAL REPORT | 2019-02-18 |
| LC Amendment and Name Change | 2018-02-26 |
| ANNUAL REPORT | 2018-01-30 |
| ANNUAL REPORT | 2017-04-23 |
| Florida Limited Liability | 2016-09-08 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
