| Entity Name: | PHYSICAL THERAPY NOW HIALEAH LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 04 Oct 2021 (3 years ago) |
| Document Number: | L21000435048 |
| FEI/EIN Number | 87-3358088 |
| Mail Address: | 12277 SW 130 STREET, MIAMI, FL, 33186, UN |
| Address: | 3595 W 20TH AVE, HIALEAH, FL 33012, USA, 115, HIALEAH, FL, 33012 |
| ZIP code: | 33012 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063177483 | 2021-11-01 | 2024-01-25 | 12277 SW 130TH ST, MIAMI, FL, 331866218, US | 3595 W 20TH AVE STE 115, HIALEAH, FL, 330124533, US | |||||||||||||||||||||||
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| Phone | +1 305-470-3399 |
| Fax | 3052030546 |
| Phone | +1 305-570-1666 |
Authorized person
| Name | MS. DONNA LEA FONDA |
| Role | CREDENTIALING DIRECTOR |
| Phone | 3054709399 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAL LICENSE |
| Number | OT11471 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ZAPATA ANDRES | Agent | 12277 SW 130 STREET, MIAMI, FL, 33186 |
| Name | Role | Address |
|---|---|---|
| ZAPATA ANDRES | Manager | 12277 SW 130 STREET, MIAMI, FL, 33186 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-12 |
| ANNUAL REPORT | 2023-01-20 |
| ANNUAL REPORT | 2022-05-23 |
| Florida Limited Liability | 2021-10-04 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
