| Entity Name: | FUNCTIONAL TRANSFORMATION LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 12 Aug 2022 (2 years ago) |
| Document Number: | L22000355108 |
| FEI/EIN Number | 88-3674485 |
| Address: | 5957 Cattlemen Lane, Sarasota, FL 34232 |
| Mail Address: | 5957 Cattlemen Lane, Sarasota, FL 34232 |
| ZIP code: | 34232 |
| County: | Sarasota |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013633031 | 2022-10-12 | 2024-03-28 | 2201 CANTU CT STE 109, SARASOTA, FL, 342326254, US | 2201 CANTU CT STE 109, SARASOTA, FL, 342326254, US | |||||||||||||||||||||||||||
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| Phone | +1 941-371-1185 |
| Fax | 9414604494 |
| Phone | +1 941-830-3749 |
Authorized person
| Name | JAMES FERRARA |
| Role | OWNER PROVIDER |
| Phone | 9418303749 |
Taxonomy
| Taxonomy Code | 225X00000X - Occupational Therapist |
| Is Primary | Yes |
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 116717600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FERRARA, JAMES | Agent | 1116 ROTONDA CIR, ROTONDA WEST, FL 33947 |
| Name | Role | Address |
|---|---|---|
| FERRARA, JAMES | Owner | 2201 CANTU CT., STE 109, SARASOTA, FL 34232 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-22 | 5957 Cattlemen Lane, Sarasota, FL 34232 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-22 | 5957 Cattlemen Lane, Sarasota, FL 34232 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-31 |
| AMENDED ANNUAL REPORT | 2023-09-05 |
| ANNUAL REPORT | 2023-02-28 |
| Florida Limited Liability | 2022-08-12 |
Date of last update: 11 Jan 2025
Sources: Florida Department of State
