| Entity Name: | ADVANCED PHYSICAL THERAPY & REHAB OF LEE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 25 Oct 2023 (a year ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 27 Dec 2023 (a year ago) |
| Document Number: | L23000486114 |
| FEI/EIN Number | 48-1301450 |
| Address: | 6314 Whiskey Creek Dr, Fort Myers, FL 33919 |
| Mail Address: | 484 Riverside Ave, Jacksonville, FL 32202 |
| ZIP code: | 33919 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1710930623 | 2006-05-19 | 2024-02-26 | PO BOX 932184, ATLANTA, GA, 311932184, US | 6314 WHISKEY CREEK DR STE D, FORT MYERS, FL, 339198762, US | |||||||||||||||||||||||||||||||||||||||
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| Phone | +1 239-432-0556 |
| Fax | 2394329727 |
Authorized person
| Name | AMANDA STREETER |
| Role | VICE PRESIDENT |
| Phone | 8006999395 |
Taxonomy
| Taxonomy Code | 261QR0401X - Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 008812000 |
| State | FL |
| Issuer | DMEPOS |
| Number | 6527110001 |
| State | FL |
| Issuer | FL DEPT OF LABOR |
| Number | 362346700 |
| State | FL |
| Issuer | BLUE CROSS BLUE SHIELD FL |
| Number | GG4 |
| State | FL |
| Name | Role |
|---|---|
| COGENCY GLOBAL INC. | Agent |
| Name | Role |
|---|---|
| H2 HOLDCO, INC. | Manager |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-22 | 6314 Whiskey Creek Dr, Fort Myers, FL 33919 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-22 | 6314 Whiskey Creek Dr, Fort Myers, FL 33919 | No data |
| LC AMENDMENT | 2023-12-27 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2023-12-27 | COGENCY GLOBAL INC. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-12-27 | 115 N. CALHOUN STREET, STE 4, TALLAHASSEE, FL 32301 | No data |
| CONVERSION | 2023-10-25 | No data | CORPORATION WAS A CONVERSION RESULT. CONVERTING CORPORATION WAS P03000021956. CONVERSION NUMBER 700000245547 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-22 |
| LC Amendment | 2023-12-27 |
| Florida Limited Liability | 2023-10-25 |
Date of last update: 09 Feb 2025
Sources: Florida Department of State
