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MARIANNA PHYSICAL & AQUATIC THERAPY, LLC - Florida Company Profile

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Company Details

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
City: Marianna
County: Jackson
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
Laurel Ruben A Manager 4285 LAFAYETTE ST, MARIANNA, FL, 32446
LAUREL Ruben A Agent 4285 LAFAYETTE ST, MARIANNA, FL, 32446

U.S. Small Business Administration Profile

Phone Number:
E-mail Address:
Fax Number:
850-415-1967
Contact Person:
RUBEN LAUREL
User ID:
P2902082
Trade Name:
MARIANNA PHYSICAL & AQUATIC THERAPY LLC

Unique Entity ID

Unique Entity ID:
EDVSL6D895J5
CAGE Code:
9CZW5
UEI Expiration Date:
2026-05-02

Business Information

Doing Business As:
MARIANNA PHYSICAL & AQUATIC THERAPY LLC
Activation Date:
2025-05-08
Initial Registration Date:
2022-09-13

Commercial and government entity program

CAGE number:
9CZW5
Status:
Active
Type:
Non-Manufacturer
CAGE Update Date:
2025-05-08
CAGE Expiration:
2030-05-08
SAM Expiration:
2026-05-02

Contact Information

POC:
RUBEN LAUREL

National Provider Identifier

NPI Number:
1679051437
Certification Date:
2021-09-10

Authorized Person:

Name:
MS. KALIEGH PAYNE LAUREL
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
208100000X - Physical Medicine & Rehabilitation Physician
Is Primary:
Yes

Contacts:

Fax:
8666305149

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2024-04-22 LAUREL, Ruben A -
REGISTERED AGENT ADDRESS CHANGED 2019-04-08 4285 LAFAYETTE ST, MARIANNA, FL 32446 -
CHANGE OF PRINCIPAL ADDRESS 2018-08-27 4285 LAFAYETTE ST, MARIANNA, FL 32446 -
CHANGE OF MAILING ADDRESS 2018-08-27 4285 LAFAYETTE ST, MARIANNA, FL 32446 -

Documents

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

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Date of last update: 01 Aug 2025

Sources: Florida Department of State