| Entity Name: | BASE PHYSICAL THERAPY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
BASE PHYSICAL THERAPY, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| 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: | 18 Jan 2012 (13 years ago) |
| Document Number: | L12000008933 |
| FEI/EIN Number |
45-4378138
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 3361 RAYMOND DIEHL BUS LANE RD, TALLAHASSEE, FL, 32308-3895, US |
| Mail Address: | 3470 RUSTLEWOOD LN., TALLAHASSEE, FL, 32312 |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1841538113 | 2013-01-22 | 2014-04-17 | PO BOX 14344, TALLAHASSEE, FL, 323174344, US | 1989 CAPITAL CIR NE, SUITE 9, TALLAHASSEE, FL, 323084493, US | |||||||||||||||||||||||||||
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| Phone | +1 850-727-5406 |
| Fax | 8507275764 |
Authorized person
| Name | THOMAS M LARSON |
| Role | PRESIDENT |
| Phone | 8505087831 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 008869300 |
| State | FL |
| Issuer | BCBSFL |
| Number | Y90SZ |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LARSON THOMAS M | Manager | 3470 RUSTLEWOOD LN., TALLAHASSEE, FL, 32312 |
| Larson Jenna | Manager | 3470 RUSTLEWOOD LN., TALLAHASSEE, FL, 32312 |
| LARSON THOMAS | Agent | 3470 RUSTLEWOOD LN., TALLAHASSEE, FL, 32312 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2018-04-15 | 3361 RAYMOND DIEHL BUS LANE RD, TALLAHASSEE, FL 32308-3895 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-12 |
| ANNUAL REPORT | 2023-03-07 |
| ANNUAL REPORT | 2022-04-21 |
| ANNUAL REPORT | 2021-04-25 |
| ANNUAL REPORT | 2020-04-29 |
| ANNUAL REPORT | 2019-04-28 |
| ANNUAL REPORT | 2018-04-15 |
| ANNUAL REPORT | 2017-09-09 |
| ANNUAL REPORT | 2016-04-23 |
| ANNUAL REPORT | 2015-04-26 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 8337057207 | 2020-04-28 | 0491 | PPP | 3361 Raymond Diehl Bus. land road, TALLAHASSEE, FL, 32308 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 01 Mar 2025
Sources: Florida Department of State
