| Entity Name: | PHYSICAL THERAPY SPECIALISTS OF PINE CASTLE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 03 Mar 2005 (20 years ago) |
| Last Event: | LC NAME CHANGE |
| Event Date Filed: | 28 Aug 2008 (16 years ago) |
| Document Number: | L05000021634 |
| FEI/EIN Number | 050618049 |
| Address: | 345 W. MICHIGAN ST., STE. 108, ORLANDO, FL, 32806, US |
| Mail Address: | 345 W. MICHIGAN ST., STE. 108, ORLANDO, FL, 32806, US |
| ZIP code: | 32806 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548217615 | 2006-05-27 | 2021-04-20 | 345 W MICHIGAN ST STE 108, ORLANDO, FL, 328064465, US | 345 W MICHIGAN ST STE 108, ORLANDO, FL, 328064465, US | |||||||||||||||||||||||
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| Phone | +1 407-888-2255 |
| Fax | 4078882446 |
Authorized person
| Name | DAVID KRAWCZYK |
| Role | OWNER / OFFICER / MANAGING MEMBER |
| Phone | 8635479793 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 891113400 |
| State | FL |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role | Address |
|---|---|---|
| KRAWCZYK DAVID E | Managing Member | 1125 NORTHERN WAY, WINTER SPRINGS, FL, 32708 |
| D'AMELIO MICHAEL R | Managing Member | 9950 Marsh Pointe Drive, ORLANDO, FL, 32832 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2015-08-12 | 345 W. MICHIGAN ST., STE. 108, ORLANDO, FL 32806 | No data |
| CHANGE OF MAILING ADDRESS | 2015-08-12 | 345 W. MICHIGAN ST., STE. 108, ORLANDO, FL 32806 | No data |
| LC NAME CHANGE | 2008-08-28 | PHYSICAL THERAPY SPECIALISTS OF PINE CASTLE, LLC | No data |
| LC NAME CHANGE | 2006-03-08 | PHYSICAL THERAPY SPECIALISTS, LLC | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-05 |
| ANNUAL REPORT | 2024-02-05 |
| ANNUAL REPORT | 2023-01-25 |
| ANNUAL REPORT | 2022-01-24 |
| ANNUAL REPORT | 2021-01-11 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-02-07 |
| ANNUAL REPORT | 2018-01-14 |
| ANNUAL REPORT | 2017-01-09 |
| ANNUAL REPORT | 2016-01-26 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 9919777107 | 2020-04-15 | 0491 | PPP | 345 W. MICHIGAN ST Suite 108, ORLANDO, FL, 32806-4465 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Feb 2025
Sources: Florida Department of State
