| Entity Name: | BACK IN FORM PHYSICAL THERAPY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Profit Corporation
BACK IN FORM PHYSICAL THERAPY, INC. is structured as a Profit Corporation, also known as a C-Corporation, a business structure recognized as a separate legal entity from its owners. This structure offers the benefit of potential tax advantages and ease of raising capital through the issuance of stock. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 27 Jul 1999 (26 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 24 May 2011 (14 years ago) |
| Document Number: | P99000066460 |
| FEI/EIN Number |
65-0938578
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 4445 Highway A1A, Suite 125, VERO BEACH, FL 32963 |
| Mail Address: | 4445 Highway A1A, Suite 125, VERO BEACH, FL 32963 |
| ZIP code: | 32963 |
| County: | Indian River |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518247873 | 2011-08-18 | 2011-08-18 | 4445 HIGHWAY A1A, SUITE 125, VERO BEACH, FL, 329635405, US | 4445 HIGHWAY A1A, SUITE 125, VERO BEACH, FL, 329635405, US | |||||||||||||||||||||||||||||||
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| Phone | +1 772-231-3676 |
| Fax | 7722313670 |
Authorized person
| Name | MICHAEL HAUSER |
| Role | OWNER/PHYSICAL THERAPIST |
| Phone | 7722313676 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| License Number | PT18268 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | STATE LICENSE |
| Number | PT18268 |
| State | FL |
| Issuer | STATE LICENSE |
| Number | PT18370 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HAUSER, MICHAEL F | Agent | 4445 Highway A1A, Suite 125, VERO BEACH, FL 32963 |
| HAUSER, MICHAEL F | President | 4445 Highway A1A, Suite 125 VERO BEACH, FL 32963 |
| Hauser, Shannon E | Vice President | 4445 Highway A1A, Suite 125 VERO BEACH, FL 32963 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2018-01-15 | HAUSER, MICHAEL F | - |
| REGISTERED AGENT ADDRESS CHANGED | 2018-01-15 | 4445 Highway A1A, Suite 125, VERO BEACH, FL 32963 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2017-03-30 | 4445 Highway A1A, Suite 125, VERO BEACH, FL 32963 | - |
| CHANGE OF MAILING ADDRESS | 2017-03-30 | 4445 Highway A1A, Suite 125, VERO BEACH, FL 32963 | - |
| PENDING REINSTATEMENT | 2011-05-24 | - | - |
| REINSTATEMENT | 2011-05-24 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | - | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-20 |
| ANNUAL REPORT | 2023-02-28 |
| ANNUAL REPORT | 2022-02-10 |
| ANNUAL REPORT | 2021-01-13 |
| ANNUAL REPORT | 2020-01-16 |
| ANNUAL REPORT | 2019-02-08 |
| ANNUAL REPORT | 2018-01-15 |
| ANNUAL REPORT | 2017-03-30 |
| ANNUAL REPORT | 2016-03-10 |
| ANNUAL REPORT | 2015-04-07 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 4755097104 | 2020-04-13 | 0455 | PPP | 4445 HIGHWAY A1A 125, VERO BEACH, FL, 32963-5443 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 01 Feb 2025
Sources: Florida Department of State
