| Entity Name: | ACUPHYSIO360, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Company
ACUPHYSIO360, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 26 Jul 2017 (8 years ago) |
| Document Number: | L17000159642 |
| FEI/EIN Number |
82-2277564
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 245 Wheelhouse Lane, Suite 1451, Lake Mary, FL 32746 |
| Mail Address: | 245 Wheelhouse Lane, Suite 1451, Lake Mary, FL 32746 |
| ZIP code: | 32746 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295372662 | 2019-12-04 | 2021-12-07 | 245 WHEELHOUSE LN STE 1451, LAKE MARY, FL, 327463696, US | 245 WHEELHOUSE LN STE 1451, LAKE MARY, FL, 327463696, US | |||||||||||||||||||||||||
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| Phone | +1 407-878-0507 |
| Fax | 8449040880 |
Authorized person
| Name | PHUONG PHAM |
| Role | MANAGER |
| Phone | 9542636019 |
Taxonomy
| Taxonomy Code | 171100000X - Acupuncturist |
| Is Primary | No |
| Taxonomy Code | 225100000X - Physical Therapist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 103490700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HO, MONTANA V | Agent | 245 Wheelhouse Lane, Suite 1451, Lake Mary, FL 32746 |
| HO, MONTANA V | Manager | 245 Wheelhouse Lane, Suite 1451 Lake Mary, FL 32746 |
| PHAM, PHUONG D | Manager | 245 Wheelhouse Lane, Suite 1451 Lake Mary, FL 32746 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000097818 | RECUPERY ACTIVE RECOVERY STUDIO | ACTIVE | 2019-09-05 | 2029-12-31 | - | 245 WHEELHOUSE LANE, SUITE 1451, LAKE MARY, FL, 32746 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-01-21 | 245 Wheelhouse Lane, Suite 1451, Lake Mary, FL 32746 | - |
| CHANGE OF MAILING ADDRESS | 2020-01-21 | 245 Wheelhouse Lane, Suite 1451, Lake Mary, FL 32746 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2020-01-21 | 245 Wheelhouse Lane, Suite 1451, Lake Mary, FL 32746 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-25 |
| ANNUAL REPORT | 2024-01-25 |
| ANNUAL REPORT | 2023-03-03 |
| ANNUAL REPORT | 2022-03-07 |
| ANNUAL REPORT | 2021-02-17 |
| ANNUAL REPORT | 2020-01-21 |
| ANNUAL REPORT | 2019-01-09 |
| ANNUAL REPORT | 2018-04-17 |
| Florida Limited Liability | 2017-07-26 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 2758028500 | 2021-02-22 | 0491 | PPP | 245 Wheelhouse Ln Ste 1451, Lake Mary, FL, 32746-3696 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 18 Feb 2025
Sources: Florida Department of State
