| Entity Name: | ACTIVE LIFE ANTI-AGING AND REGENERATIVE MEDICINE, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 03 Aug 2017 (8 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year ago) |
| Document Number: | P17000065538 |
| FEI/EIN Number | 82-2401573 |
| Address: | 8320 WEST SUNRISE BLVD., SUITE 111, PLANTATION, FL, 33322 |
| Mail Address: | 8320 WEST SUNRISE BLVD., SUITE 111, PLANTATION, FL, 33322 |
| ZIP code: | 33322 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1922651843 | 2019-07-19 | 2019-07-19 | 8320 W SUNRISE BLVD, PLANTATION, FL, 333225435, US | 8320 W SUNRISE BLVD, PLANTATION, FL, 333225435, US | |||||||||||||||
|
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| Phone | +1 954-423-0020 |
| Fax | 9544233091 |
Authorized person
| Name | ROBERT J HANOPOLE |
| Role | PRESIDENT |
| Phone | 9544230020 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| HANOPOLE ROBERT | Agent | 17363 Sea Blossom Way, Boca Raton, FL, 33496 |
| Name | Role | Address |
|---|---|---|
| HANOPOLE ROBERT | Vice President | 17363 Sea Blossom Way, Boca Raton, FL, 33496 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-07-27 | 17363 Sea Blossom Way, Boca Raton, FL 33496 | No data |
| REGISTERED AGENT NAME CHANGED | 2019-07-30 | HANOPOLE, ROBERT | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2022-04-26 |
| ANNUAL REPORT | 2021-07-27 |
| ANNUAL REPORT | 2020-06-23 |
| Reg. Agent Change | 2019-07-30 |
| ANNUAL REPORT | 2019-04-25 |
| ANNUAL REPORT | 2018-02-25 |
| Domestic Profit | 2017-08-03 |
| Off/Dir Resignation | 2017-07-30 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
