| Entity Name: | PHYSIO ACTIVE THERAPY & WELLNESS CORP. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 05 Mar 2021 (4 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 11 Aug 2022 (2 years ago) |
| Document Number: | P21000023336 |
| FEI/EIN Number | 86-2682034 |
| Address: | 6845 PEMBROKE ROAD, PEMBROKE PINES, FL, 33023, US |
| Mail Address: | 6845 PEMBROKE ROAD, PEMBROKE PINES, FL, 33023, US |
| ZIP code: | 33023 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891550463 | 2024-02-14 | 2024-02-14 | 6845 PEMBROKE RD, PEMBROKE PINES, FL, 330232678, US | 6845 PEMBROKE RD, PEMBROKE PINES, FL, 330232678, US | |||||||||||||||
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| Phone | +1 954-362-4302 |
| Fax | 3056753311 |
Authorized person
| Name | FERNANDO MOREL |
| Role | ADMINISTRATOR |
| Phone | 9543624302 |
Taxonomy
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| TABORA HILDA | Agent | 8964 SW 212TH LN, CUTLER BAY, FL, 33189 |
| Name | Role | Address |
|---|---|---|
| MOREL FERNANDO A | Director | 6845 PEMBROKE ROAD, PEMBROKE PINES, FL, 33023 |
| TABORA HILDA | Director | 6845 PEMBROKE ROAD, PEMBROKE PINES, FL, 33023 |
| Name | Role | Address |
|---|---|---|
| TABORA HILDA | Vice President | 6845 PEMBROKE ROAD, PEMBROKE PINES, FL, 33023 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000033230 | PHYSIO HEALING THERAPY | ACTIVE | 2023-03-12 | 2028-12-31 | No data | 6845 PEMBROKE RD, PEMBROKE PINES, FL, 33023 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2023-03-03 | 8964 SW 212TH LN, CUTLER BAY, FL 33189 | No data |
| AMENDMENT | 2022-08-11 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2022-08-11 | TABORA, HILDA | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-05 |
| ANNUAL REPORT | 2023-03-03 |
| AMENDED ANNUAL REPORT | 2022-11-11 |
| Amendment | 2022-08-11 |
| ANNUAL REPORT | 2022-03-09 |
| Domestic Profit | 2021-03-05 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
