| Entity Name: | ADVANCED PHYSICAL THERAPY OF LAKE COUNTY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 21 Sep 2001 (23 years ago) |
| Document Number: | P01000092899 |
| FEI/EIN Number | 593747797 |
| Address: | 4400 HIGHWAY 19, Mt Dora, FL, 32757, US |
| Mail Address: | 4400 N Highway 19A, Suite A1, Mount Dora, FL, 32757, US |
| ZIP code: | 32757 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1427173640 | 2007-03-20 | 2022-07-21 | 3800 LAKE CENTER DR STE B3, MOUNT DORA, FL, 327572208, US | 3800 LAKE CENTER DR STE B3, MOUNT DORA, FL, 327572208, US | |||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 352-735-8543 |
| Fax | 3527358551 |
Authorized person
| Name | MRS. DENISE ANN MONERT |
| Role | OWNER |
| Phone | 3527358543 |
Taxonomy
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| License Number | PT17889 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | ACN GROUP - DENISE MONERT |
| Number | 829437 |
| State | FL |
| Issuer | MEDICAID |
| Number | 887503100 |
| State | FL |
| Issuer | ACN GROUP - S. HOUSTOUN |
| Number | 681950 |
| State | FL |
| Issuer | AETNA PROVIDER ID |
| Number | 7830261 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MONERT DENISE | Agent | 121 E BLUE WATER EDGE DR, EUSTIS, FL, 32736 |
| Name | Role | Address |
|---|---|---|
| MONERT DENISE A | Director | 121 E BLUE WATER EDGE DRIVE, EUSTIS, FL, 32736 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2021-04-05 | 4400 HIGHWAY 19, STE A1, Mt Dora, FL 32757 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-05-21 | 4400 HIGHWAY 19, STE A1, Mt Dora, FL 32757 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-03-12 | 121 E BLUE WATER EDGE DR, EUSTIS, FL 32736 | No data |
| REGISTERED AGENT NAME CHANGED | 2006-03-15 | MONERT, DENISE | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-20 |
| ANNUAL REPORT | 2023-02-08 |
| ANNUAL REPORT | 2022-07-19 |
| ANNUAL REPORT | 2021-04-05 |
| ANNUAL REPORT | 2020-01-21 |
| ANNUAL REPORT | 2019-02-22 |
| ANNUAL REPORT | 2018-04-09 |
| ANNUAL REPORT | 2017-01-10 |
| ANNUAL REPORT | 2016-02-09 |
| ANNUAL REPORT | 2015-01-13 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
