| Entity Name: | FOREVER ACTIVE PHYSICAL THERAPY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 04 Oct 2022 (2 years ago) |
| Document Number: | L22000427539 |
| FEI/EIN Number | 92-0590618 |
| Address: | 10 RIDGE ROAD, PALM COAST, FL 32137 |
| Mail Address: | 10 RIDGE ROAD, PALM COAST, FL 32137 |
| ZIP code: | 32137 |
| County: | Flagler |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1316662364 | 2022-10-11 | 2022-10-11 | 10 RIDGE RD, PALM COAST, FL, 321379808, US | 10 RIDGE RD, PALM COAST, FL, 321379808, US | |||||||||||||
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| Phone | +1 732-575-3275 |
Authorized person
| Name | BRADLEY PUGLISI |
| Role | PRESIDENT |
| Phone | 7325753275 |
Taxonomy
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| PUGLISI, BRADLEY B | Agent | 10 RIDGE ROAD, PALM COAST, FL 32137 |
| Name | Role | Address |
|---|---|---|
| PUGLISI, BRADLEY B | Manager | 10 RIDGE ROAD, PALM COAST, FL 32137 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-09-21 |
| Florida Limited Liability | 2022-10-04 |
Date of last update: 11 Feb 2025
Sources: Florida Department of State
