| Entity Name: | FTX MEDICAL, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 13 May 2019 (6 years ago) |
| Date of dissolution: | 23 Sep 2022 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (2 years ago) |
| Document Number: | L19000129713 |
| FEI/EIN Number | 84-2364984 |
| Address: | 7815 NW BEACON SQUARE BLVD, SUITE 201, BOCA RATON, FL, 33487 |
| Mail Address: | 7815 NW BEACON SQUARE BLVD, SUITE 201, BOCA RATON, FL, 33487 |
| ZIP code: | 33487 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1437708799 | 2019-09-10 | 2019-09-10 | 7815 NW BEACON SQUARE BLVD STE 201, BOCA RATON, FL, 334871345, US | 7815 NW BEACON SQUARE BLVD STE 201, BOCA RATON, FL, 334871345, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 561-995-0136 |
Authorized person
| Name | OCTAVIO CIFUENTES |
| Role | OWNER |
| Phone | 5619950136 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| Is Primary | Yes |
| Taxonomy Code | 171100000X - Acupuncturist |
| Is Primary | No |
| Taxonomy Code | 225100000X - Physical Therapist |
| Is Primary | No |
| Taxonomy Code | 225700000X - Massage Therapist |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MULTI-SPECIALITY GROUP |
| Number | 193200000X |
| Issuer | PHYSICAL THERAPIST |
| Number | 225100000X |
| Name | Role | Address |
|---|---|---|
| FRYE ROXANNE | Agent | 7815 NW BEACON SQUARE BLVD, BOCA RATON, FL, 33487 |
| Name | Role | Address |
|---|---|---|
| CIFUENTES OCTAVIO | Manager | 7815 NW BEACON SQUARE BLVD, STE 201, BOCA RATON, FL, 33487 |
| KHATAMI HESSAM | Manager | 7815 NW BEACON SQUARE BLVD, STE 201, BOCA RATON, FL, 33487 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2021-04-15 |
| ANNUAL REPORT | 2020-06-30 |
| Florida Limited Liability | 2019-05-13 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
