| Entity Name: | PT AND SPINAL REHAB LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 13 Mar 2015 (10 years ago) |
| Date of dissolution: | 23 Sep 2016 (8 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2016 (8 years ago) |
| Document Number: | L15000059000 |
| Address: | 17521 US HIGHWAY 441, SUITE 6, CENTURY PLAZA, MOUNT DORA, FL 32757 |
| Mail Address: | 17521 US HIGHWAY 441, SUITE 6, CENTURY PLAZA, MOUNT DORA, FL 32757 |
| ZIP code: | 32757 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1871974683 | 2015-06-17 | 2015-06-17 | 17521 US HIGHWAY 441, MOUNT DORA, FL, 327576737, US | 17521 US HIGHWAY 441, MOUNT DORA, FL, 327576737, US | |||||||||||||||||||||||||
|
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| Phone | +1 352-735-4385 |
| Fax | 3527354386 |
Authorized person
| Name | DANIEL JOSEPH THOMAS |
| Role | OWNER |
| Phone | 3527354385 |
Taxonomy
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| License Number | PT27107 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE INDIVIDUAL NPI |
| Number | 1942608187 |
| State | FL |
| Name | Role |
|---|---|
| THOMAS DANIEL COMPANY INC. | Agent |
| Name | Role | Address |
|---|---|---|
| THOMAS, DANIEL J | Manager | 3201 VILLAGE LANE, MOUNT DORA, FL 32757 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| Name | Date |
|---|---|
| Florida Limited Liability | 2015-03-13 |
Date of last update: 21 Jan 2025
Sources: Florida Department of State
