| Entity Name: | GAINESVILLE PHYSICAL THERAPY & WELLNESS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 17 Aug 2006 (18 years ago) |
| Last Event: | LC STMNT OF AUTHORITY 21 |
| Event Date Filed: | 24 Apr 2020 (5 years ago) |
| Document Number: | L06000081372 |
| FEI/EIN Number | 205418194 |
| Address: | 4113-C NW 6TH STREET, GAINESVILLE, FL, 32609, US |
| Mail Address: | 4113-c NW 6th Street, Gainesville, FL, 32609, US |
| ZIP code: | 32609 |
| County: | Alachua |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1205910320 | 2006-10-25 | 2010-03-11 | 4113 NW 6TH ST STE C, GAINESVILLE, FL, 326090731, US | 4113 NW 6TH ST STE C, GAINESVILLE, FL, 326090731, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 352-376-6300 |
| Fax | 3523720661 |
Authorized person
| Name | MR. DAVID C LOWER |
| Role | MEMBER MANAGER |
| Phone | 3523766300 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| License Number | PT12687 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | Y912S |
| State | FL |
| Issuer | RAILROAD MEDICARE |
| Number | DH0372 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LOWER DAVID C | Agent | 4113-C NW 6TH STREET, GAINESVILLE, FL, 32609 |
| Name | Role | Address |
|---|---|---|
| LOWER DAVID C | Manager | 4113-C NW 6TH STREET, GAINESVILLE, FL, 32609 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC STMNT OF AUTHORITY | 2020-04-24 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2018-01-05 | 4113-C NW 6TH STREET, GAINESVILLE, FL 32609 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-01-05 | 4113-C NW 6TH STREET, GAINESVILLE, FL 32609 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-01-05 | 4113-C NW 6TH STREET, GAINESVILLE, FL 32609 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-02 |
| ANNUAL REPORT | 2024-01-03 |
| ANNUAL REPORT | 2023-01-03 |
| ANNUAL REPORT | 2022-01-03 |
| ANNUAL REPORT | 2021-01-06 |
| CORLCAUTH | 2020-04-24 |
| ANNUAL REPORT | 2020-01-02 |
| ANNUAL REPORT | 2019-04-29 |
| ANNUAL REPORT | 2018-01-05 |
| ANNUAL REPORT | 2017-01-07 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
