| Entity Name: | MARIANNA PHYSICAL & AQUATIC THERAPY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 12 Jul 2018 (7 years ago) |
| Document Number: | L18000168961 |
| FEI/EIN Number | 83-1272643 |
| Address: | 4285 LAFAYETTE ST, MARIANNA, FL, 32446, US |
| Mail Address: | 4285 LAFAYETTE ST, MARIANNA, FL, 32446, US |
| ZIP code: | 32446 |
| County: | Jackson |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1679051437 | 2018-08-03 | 2021-09-10 | 4285 LAFAYETTE ST, MARIANNA, FL, 324462919, US | 4285 LAFAYETTE ST, MARIANNA, FL, 324462919, US | |||||||||||||||||
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| Phone | +1 850-596-0218 |
| Fax | 8666305149 |
| Phone | +1 850-482-0080 |
Authorized person
| Name | MS. KALIEGH PAYNE LAUREL |
| Role | OWNER |
| Phone | 8505960218 |
Taxonomy
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LAUREL Ruben A | Agent | 4285 LAFAYETTE ST, MARIANNA, FL, 32446 |
| Name | Role | Address |
|---|---|---|
| Laurel Ruben A | Manager | 4285 LAFAYETTE ST, MARIANNA, FL, 32446 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-04-22 | LAUREL, Ruben A | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-04-08 | 4285 LAFAYETTE ST, MARIANNA, FL 32446 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-08-27 | 4285 LAFAYETTE ST, MARIANNA, FL 32446 | No data |
| CHANGE OF MAILING ADDRESS | 2018-08-27 | 4285 LAFAYETTE ST, MARIANNA, FL 32446 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-22 |
| ANNUAL REPORT | 2023-02-14 |
| ANNUAL REPORT | 2022-01-31 |
| ANNUAL REPORT | 2021-03-17 |
| ANNUAL REPORT | 2020-06-30 |
| ANNUAL REPORT | 2019-04-08 |
| Florida Limited Liability | 2018-07-12 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
