| Entity Name: | PINECREST PT- SOUTH L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 26 Sep 2017 (7 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 17 Oct 2017 (7 years ago) |
| Document Number: | L17000199193 |
| FEI/EIN Number | 82-2947822 |
| Address: | 13101 SOUTH DIXIE HIGHWAY, SUITE 330, MIAMI, FL 33156 |
| Mail Address: | PO BOX 331921, MIAMI, FL 33233 |
| ZIP code: | 33156 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1427562073 | 2017-11-18 | 2020-07-21 | 13101 S DIXIE HWY STE 330, MIAMI, FL, 331566530, US | 13101 S DIXIE HWY STE 330, MIAMI, FL, 331566530, US | |||||||||||||||||||||||||
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| Phone | +1 305-722-0568 |
| Fax | 3056700899 |
Authorized person
| Name | MR. RONALD YACOUB |
| Role | OWNER |
| Phone | 3057220568 |
Taxonomy
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| License Number | PT18067 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | APPLYING FOR MCR |
| Number | 0000000 |
| State | FL |
| Name | Role |
|---|---|
| AGE RE SERVICES, LLC | Agent |
| Name | Role |
|---|---|
| PINECREST PHYSICAL THERAPY HOLDINGS, LLC | Manager |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2017-10-17 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-25 |
| ANNUAL REPORT | 2023-04-21 |
| ANNUAL REPORT | 2022-04-11 |
| ANNUAL REPORT | 2021-04-12 |
| ANNUAL REPORT | 2020-02-18 |
| ANNUAL REPORT | 2019-03-08 |
| ANNUAL REPORT | 2018-02-16 |
| LC Amendment | 2017-10-17 |
| Florida Limited Liability | 2017-09-26 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 5385547409 | 2020-05-12 | 0455 | PPP | 13101 South Dixie Highway Suite 330, Pinecrest, FL, 33156 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 17 Feb 2025
Sources: Florida Department of State
