| Entity Name: | ADVANCED INTEGRATED MANUAL PHYSICAL THERAPY, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 06 Jun 2002 (23 years ago) |
| Document Number: | P02000062636 |
| FEI/EIN Number | 010711028 |
| Address: | 1501 CORPORATE DRIVE, SUITE 110, BOYNTON BEACH, FL, 33426 |
| Mail Address: | 1501 CORPORATE DRIVE, SUITE 110, BOYNTON BEACH, FL, 33426 |
| ZIP code: | 33426 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1831277078 | 2006-11-02 | 2011-01-28 | 1800 W WOOLBRIGHT RD, SUITE 101, BOYNTON BEACH, FL, 334266398, US | 1800 W WOOLBRIGHT RD, SUITE 101, BOYNTON BEACH, FL, 334266398, US | |||||||||||||||||||
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| Phone | +1 561-733-7677 |
| Fax | 5617337074 |
Authorized person
| Name | MR. DAVID LIGHT |
| Role | OWNER |
| Phone | 5617337677 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| License Number | PT18042 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LIGHT DAVID M | Agent | 1501 CORPORATE DRIVE, BOYNTON BEACH, FL, 33426 |
| Name | Role | Address |
|---|---|---|
| LIGHT DAVID M | President | 1501 Corporate Dr, BOYNTON BEACH, FL, 33426 |
| Name | Role | Address |
|---|---|---|
| Light Kelley | Vice President | 1501 Corporate Dr, BOYNTON BEACH, FL, 33426 |
| Young Paul | Vice President | 1501 Corporate Dr, BOYNTON BEACH, FL, 33426 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G12000036478 | REGIONAL PHYSIOTHERAPY CENTRE | EXPIRED | 2012-04-17 | 2017-12-31 | No data | 1800 WEST WOOLBRIGHT ROAD, SUITE 101, BOYNTON BEACH, FL, 33426 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISS W/ NOTICE | 2019-12-20 | No data | No data |
| REINSTATEMENT | 2016-01-26 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
