| Entity Name: | MAXICARE PHYSICAL THERAPY OF FLORIDA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 10 Aug 2022 (3 years ago) |
| Document Number: | L22000351569 |
| FEI/EIN Number | 88-3636455 |
| Address: | 5285 SUMMERLIN RD., STE 101, FORT MYERS, FL 33919 |
| Mail Address: | PO Box 61022, FORT MYERS, FL 33906 |
| ZIP code: | 33919 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891401410 | 2023-01-26 | 2023-01-26 | 5285 SUMMERLIN RD STE 101, FORT MYERS, FL, 339197601, US | 5285 SUMMERLIN RD STE 101, FORT MYERS, FL, 339197601, US | |||||||||||||
|
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| Phone | +1 954-408-1920 |
Authorized person
| Name | FREYA ANN ESTINOS |
| Role | PROVIDER/PART OWNER |
| Phone | 9544081920 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MASCARINAS, LEMUEL | Agent | 5285 SUMMERLIN RD, STE 101, FORT MYERS, FL 33919 |
| Name | Role | Address |
|---|---|---|
| MASCARINAS, LEMUEL | Authorized Member | 5285 SUMMERLIN RD STE 101, FORT MYERS, FL 33919 |
| CRUZ, JOHN MICHAEL D | Authorized Member | 5285 SUMMERLIN RD STE 101, FORT MYERS, FL 33919 |
| ESTINOS, FREYA ANN | Authorized Member | 5285 SUMMERLIN RD STE 101, FORT MYERS, FL 33919 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2023-01-30 | 5285 SUMMERLIN RD., STE 101, FORT MYERS, FL 33919 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-08 |
| ANNUAL REPORT | 2023-01-30 |
| Florida Limited Liability | 2022-08-10 |
Date of last update: 11 Feb 2025
Sources: Florida Department of State
