| Entity Name: | LEGENDARY PHYSICAL THERAPY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
LEGENDARY 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: | 01 May 2017 (8 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 04 Oct 2023 (2 years ago) |
| Document Number: | L17000095754 |
| FEI/EIN Number |
82-2080815
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 410 N. Palafox St, Pensacola, FL, 32501, US |
| Mail Address: | PO BOX 13066, Pensacola, FL, 32591, US |
| ZIP code: | 32501 |
| County: | Escambia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1578089983 | 2017-08-17 | 2021-10-28 | PO BOX 6568, PENSACOLA, FL, 325030568, US | 410 N PALAFOX ST, PENSACOLA, FL, 325013919, US | |||||||||||||||||||||||||||||||
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| Phone | +1 850-478-1312 |
| Fax | 8504749060 |
| Phone | +1 850-332-7681 |
| Fax | 8505121188 |
Authorized person
| Name | DR. LOUIE WATKINS III |
| Role | PHYSICAL THERAPIST |
| Phone | 8503804377 |
Taxonomy
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 022219700 |
| State | FL |
| Issuer | LOUIE WATKINS III NPI NUMBER |
| Number | 1568589588 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Williams Elawnto RCEO | Manager | PO BOX 13066, Pensacola, FL, 32591 |
| WATKINS LOUIE III | Chief Operating Officer | 7091 HOMEPLACE LN, MOLINO, FL, 32577 |
| WILLIAMS ELAWNTO RCEO | Agent | 410 N. Palafox St, Pensacola, FL, 32501 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2023-10-04 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | - | - |
| CHANGE OF MAILING ADDRESS | 2021-01-05 | 410 N. Palafox St, Pensacola, FL 32501 | - |
| REGISTERED AGENT NAME CHANGED | 2020-10-05 | WILLIAMS, ELAWNTO R, CEO | - |
| REGISTERED AGENT ADDRESS CHANGED | 2020-10-05 | 410 N. Palafox St, Pensacola, FL 32501 | - |
| REINSTATEMENT | 2020-10-05 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2020-10-05 | 410 N. Palafox St, Pensacola, FL 32501 | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | - | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-01 |
| REINSTATEMENT | 2023-10-04 |
| ANNUAL REPORT | 2022-01-29 |
| ANNUAL REPORT | 2021-01-25 |
| REINSTATEMENT | 2020-10-05 |
| ANNUAL REPORT | 2019-04-10 |
| ANNUAL REPORT | 2018-06-28 |
| Florida Limited Liability | 2017-05-01 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 8861447202 | 2020-04-28 | 0491 | PPP | 410 N PALAFOX ST, PENSACOLA, FL, 32501-3919 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Apr 2025
Sources: Florida Department of State
