| Entity Name: | BOOST PT, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 04 Aug 2020 (5 years ago) |
| Document Number: | L20000233669 |
| FEI/EIN Number | 85-2685153 |
| Address: | 1301 PLANTATION ISLAND DR, STE 108, SAINT AUGUSTINE, FL 32080 |
| Mail Address: | 1301 PLANTATION ISLAND DR, STE 108, SAINT AUGUSTINE, FL 32080 |
| ZIP code: | 32080 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043815392 | 2020-12-03 | 2020-12-10 | 1093 A1A BEACH BLVD # 198, SAINT AUGUSTINE, FL, 320806733, US | 150 SOUTHPARK BLVD STE 204D, SAINT AUGUSTINE, FL, 320865179, US | |||||||||||||||
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| Phone | +1 904-770-1481 |
| Fax | 9046159993 |
Authorized person
| Name | DR. MITCHELL GERALD PLANA BARROS |
| Role | DOCTOR OF PHYSICAL THERAPY |
| Phone | 9043152881 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| Is Primary | Yes |
| Name | Role |
|---|---|
| CLUKEY & TEBAULT, LLC | Agent |
| Name | Role | Address |
|---|---|---|
| BARROS, MITCHELL | Manager | 1301 PLANTATION ISLAND DR, STE 108, SAINT AUGUSTINE, FL 32080 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000110096 | BOOST PHYSIOTHERAPY | ACTIVE | 2020-08-25 | 2025-12-31 | No data | 1301 PLANTATION ISLAND DR, STE 108, SAINT AUGUSTINE, FL, 32080 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-27 | 201 OWENS AVE, Unit A, SAINT AUGUSTINE, FL 32080 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-24 |
| ANNUAL REPORT | 2023-04-27 |
| ANNUAL REPORT | 2022-04-26 |
| ANNUAL REPORT | 2021-04-22 |
| Florida Limited Liability | 2020-08-04 |
Date of last update: 14 Feb 2025
Sources: Florida Department of State
