| Entity Name: | PHYSICAL THERAPY NOW SANFORD LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 11 Feb 2021 (4 years ago) |
| Document Number: | L21000072800 |
| FEI/EIN Number | 86-2185892 |
| Address: | 241 BELLAGIO CIRCLE, SANFORD, FL 32771 |
| Mail Address: | 1544 LANGHAM TERRACE, LAKE MARY, FL 32746 |
| ZIP code: | 32771 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1326633165 | 2021-03-03 | 2021-03-03 | 241 BELLAGIO CIR, SANFORD, FL, 327715001, US | 241 BELLAGIO CIR, SANFORD, FL, 327715001, US | |||||||||||||||||||||||||
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| Phone | +1 305-570-1666 |
| Fax | 3052030546 |
Authorized person
| Name | MR. SHADI AWWAD |
| Role | OWNER |
| Phone | 8326282759 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| Is Primary | No |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAL LICENSE |
| Number | PT19324 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| AWWAD, SHADI | Agent | 1544 LANGHAM TERRACE, LAKE MARY, FL 32746 |
| Name | Role | Address |
|---|---|---|
| AWWAD, SHADI | Authorized Person | 1544 LANGHAM TERRACE, LAKE MARY, FL 32746 |
| TALIAFERRO, CHARLES A, JR. | Authorized Person | 1400 ENCORE PLACE, APT 432, LAKE MARY, FL 32746 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-08 |
| ANNUAL REPORT | 2023-04-08 |
| ANNUAL REPORT | 2022-01-31 |
| Florida Limited Liability | 2021-02-11 |
Date of last update: 14 Feb 2025
Sources: Florida Department of State
