Provider Profile

FITNESS QUEST- PUNTA GORDA LLC

Health Care Clinic

FACILITY PROFILE

Facility Closed image
Street Address
  • 530 E OLYMPIA AVE STE 112
    PUNTA GORDA, FL 33950
    County: Charlotte
  • Phone: (941) 575-7300
Mailing Address
  • 11045 TAMIAMI TRL S
    NORTH PORT, FL 34287-1072
    County: Sarasota
  • Phone: (941) 575-7300
AHCA Reports
Inspection Reports
Inspection Details
Facility Information:
Facility/Provider Type:Health Care Clinic
Medical or Clinic Director:JASON R BACH-RANDOLPH
Administrator:JASON REID NIPPERT
Owner/Licensee:FITNESS QUEST PUNTA GORDA LLC
Owner/Licensee Since:10/16/2006

NamePositionOwnership
HERBERT SILVERSTEINBOARD MEMBER/OFFICER30%
JASON REID NIPPERTBOARD MEMBER/OFFICER30%
MACKENZIE MAY BARTRUFFBOARD MEMBER/OFFICER30%
ROBERT WARNER LOVELLBOARD MEMBER/OFFICER9%
Profit Status:For-Profit
Licensed Beds:Not Available
AHCA Number (File Number):6300
AHCA Field Office:08
License Number:185525
Current License Effective:3/1/2023
Current License Expires:2/28/2025
License Status:FAILED TO RENEW
Services/Characteristics
Specialty:PIP Recipient
Type:Fixed Location
Legal Actions
Please note the legal actions above may have been issued to a prior owner. The Final Order displays the name of the licensee responsible for the legal action that was taken.
Date Initiated Case # Case Type Violation Fine Amount Date Imposed
3/22/20192019011881FineSurvey$5,500.009/10/2020

Important information and facility/provider definitions can be found in the Glossary.

Attn Providers: Requests for changes in data must be sent in writing to the AHCA licensing office.