| Entity Name: | DYNAMIC THERAPY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 10 Nov 1998 (26 years ago) |
| Date of dissolution: | 23 Sep 2011 (13 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2011 (13 years ago) |
| Document Number: | P98000095071 |
| FEI/EIN Number | 593542141 |
| Address: | 4734 EXPLORATION AVE, LAKELAND, FL, 33812 |
| Mail Address: | 4734 EXPLORATION AVE, LAKELAND, FL, 33812 |
| ZIP code: | 33812 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1316016801 | 2006-11-07 | 2008-05-13 | 4734 EXPLORATION AVE, LAKELAND, FL, 338123319, US | 4734 EXPLORATION AVE, LAKELAND, FL, 338123319, US | |||||||||||||||||||||||||
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| Phone | +1 863-648-2333 |
| Fax | 8636482888 |
Authorized person
| Name | MRS. BERNADETTE CHUA OCAMPOS |
| Role | VICE-PRESIDENT |
| Phone | 8636482333 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| License Number | PT10695 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS PROVIDER NUMBER |
| Number | Y8050 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| VICENT CHONG ARIEL | Agent | 4734 EXPLORATION AVE, LAKELAND, FL, 33812 |
| Name | Role | Address |
|---|---|---|
| VICENT CHONG ARIEL | President | 4734 EXPLORATION AVE, LAKELAND, FL, 33812 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2010-01-29 | VICENT CHONG, ARIEL | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-05-02 | 4734 EXPLORATION AVE, LAKELAND, FL 33812 | No data |
| CHANGE OF MAILING ADDRESS | 2008-05-02 | 4734 EXPLORATION AVE, LAKELAND, FL 33812 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2008-05-02 | 4734 EXPLORATION AVE, LAKELAND, FL 33812 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2010-02-16 |
| ANNUAL REPORT | 2010-01-29 |
| ANNUAL REPORT | 2010-01-08 |
| ANNUAL REPORT | 2009-11-06 |
| ANNUAL REPORT | 2009-10-11 |
| ANNUAL REPORT | 2009-06-22 |
| ANNUAL REPORT | 2008-05-02 |
| ANNUAL REPORT | 2007-05-07 |
| ANNUAL REPORT | 2006-05-01 |
| ANNUAL REPORT | 2005-04-22 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
