| Entity Name: | PHYSICAL THERAPY INTERNET, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 22 Oct 1997 (27 years ago) |
| Document Number: | P97000091243 |
| FEI/EIN Number | 650805926 |
| Address: | 14350 SW Kanner HWY, Indiantown, FL, 34956, US |
| Mail Address: | 7993 Steeplechase Court, Port Saint Lucie, FL, 34986, US |
| ZIP code: | 34956 |
| County: | Martin |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114256179 | 2009-12-21 | 2014-02-05 | 15516 SW OSCEOLA ST, SUITE B, INDIANTOWN, FL, 349563414, US | 15516 SW OSCEOLA ST, SUITE B, INDIANTOWN, FL, 349563414, US | |||||||||||||||||||
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| Phone | +1 772-597-1112 |
| Fax | 7725971116 |
Authorized person
| Name | MR. MUHAMMAD SYED NOORUDDIN |
| Role | DIRECTOR OF REHABILITATION |
| Phone | 7725971112 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| License Number | PT10426 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| NOORUDDIN MUHAMMAD | Agent | 7993 Steeplechase Court, Port Saint Lucie, FL, 34986 |
| Name | Role | Address |
|---|---|---|
| Nooruddin Muhammad | President | 7993 Steeplechase Court, Port Saint Lucie, FL, 34986 |
| Name | Role | Address |
|---|---|---|
| Nausba Tariq | Vice President | 817 SW 42 Terr, Okeechobee, FL, 34974 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000032400 | PHYSICAL THERAPY OF INDIANTOWN | ACTIVE | 2021-03-08 | 2026-12-31 | No data | 14350 SW KANNER HWY, INDIANTOWN, FL, 34956 |
| G09000160547 | PHYSICAL THERAPY OF INDIANTOWN | EXPIRED | 2009-09-30 | 2014-12-31 | No data | 14350 SW KANNER HWY, INDIANTOWN, FL, 34956 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| REINSTATEMENT | 2001-11-13 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1999-09-24 | No data | No data |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
