| Entity Name: | ADVANCED HEALTH PHYSICAL THERAPY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 26 Apr 1999 (26 years ago) |
| Document Number: | P99000038494 |
| FEI/EIN Number | 650923045 |
| Address: | 4700 SW 51ST STREET, DAVIE, FL, 33314, US |
| Mail Address: | P.O. BOX 203, Dania Beach, FL, 33004, US |
| ZIP code: | 33314 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598869612 | 2006-09-11 | 2019-03-18 | 966 NAUTILUS ISLE, DANIA BEACH, FL, 330042356, US | 7796 NW 44TH ST, LAUDERHILL, FL, 333516204, US | |||||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 954-476-5928 |
| Fax | 9545307240 |
| Phone | +1 954-353-8847 |
| Fax | 9545332852 |
Authorized person
| Name | MR. DANIELE B D'AMBROSIO |
| Role | PRESIDENT |
| Phone | 9546083075 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| License Number | 17717 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 225X00000X - Occupational Therapist |
| License Number | 11462 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 235Z00000X - Speech-Language Pathologist |
| License Number | 0001575 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 889774300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| D'AMBROSIO DANIELE | Agent | 966 NAUTILUS ISLE, DANIA BEACH, FL, 33004 |
| Name | Role | Address |
|---|---|---|
| D'AMBROSIO DANIELE | President | 966 NAUTILUS ISLE, DANIA BEACH, FL, 33004 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-09-14 | 4700 SW 51ST STREET, SUITE 202, DAVIE, FL 33314 | No data |
| CHANGE OF MAILING ADDRESS | 2016-01-26 | 4700 SW 51ST STREET, SUITE 202, DAVIE, FL 33314 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2011-02-01 | 966 NAUTILUS ISLE, DANIA BEACH, FL 33004 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-04 |
| ANNUAL REPORT | 2023-02-17 |
| ANNUAL REPORT | 2022-02-18 |
| ANNUAL REPORT | 2021-02-14 |
| ANNUAL REPORT | 2020-03-05 |
| ANNUAL REPORT | 2019-03-18 |
| ANNUAL REPORT | 2018-02-01 |
| ANNUAL REPORT | 2017-02-11 |
| ANNUAL REPORT | 2016-01-26 |
| ANNUAL REPORT | 2015-01-20 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
