| Entity Name: | ACTIVEFIT REHAB PHYSICAL THERAPY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 13 Jan 2017 (8 years ago) |
| Document Number: | L17000011701 |
| FEI/EIN Number | 81-5040350 |
| Address: | 4649 CLYDE MORRIS BLVD, PORT ORANGE, FL, 32129, US |
| Mail Address: | 4649 CLYDE MORRIS BLVD, PORT ORANGE, FL, 32129, US |
| ZIP code: | 32129 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114468873 | 2017-03-14 | 2017-06-28 | 4649 CLYDE MORRIS BLVD UNIT 607, PORT ORANGE, FL, 321293003, US | 4649 CLYDE MORRIS BLVD UNIT 607, PORT ORANGE, FL, 321293003, US | |||||||||||||||||
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| Phone | +1 386-214-2663 |
Authorized person
| Name | RATREE LERTKITCHAROENPON |
| Role | PRESIDENT & COO |
| Phone | 3864512185 |
Taxonomy
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| License Number | PT13789 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LERTKITCHAROENPON RATREE | Agent | 1849 FOROUGH CIRCLE, PORT ORANGE, FL, 32128 |
| Name | Role | Address |
|---|---|---|
| LERTKITCHAROENPON RATREE | President | 4649 CLYDE MORRIS BLVD, PORT ORANGE, FL, 32129 |
| Name | Role | Address |
|---|---|---|
| Lertkitcharoenpon Wirat | Manager | 1849 Forough Cir, Port Orange, FL, 32128 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2018-03-13 | 4649 CLYDE MORRIS BLVD, 607, PORT ORANGE, FL 32129 | No data |
| CHANGE OF MAILING ADDRESS | 2018-03-13 | 4649 CLYDE MORRIS BLVD, 607, PORT ORANGE, FL 32129 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-21 |
| ANNUAL REPORT | 2023-04-16 |
| ANNUAL REPORT | 2022-04-28 |
| ANNUAL REPORT | 2021-04-28 |
| ANNUAL REPORT | 2020-03-19 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-03-13 |
| Florida Limited Liability | 2017-01-13 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
