| Entity Name: | THRIVE INTEGRATED MEDICAL, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 11 Mar 2019 (6 years ago) |
| Date of dissolution: | 23 Sep 2022 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (2 years ago) |
| Document Number: | L19000068444 |
| FEI/EIN Number | 59-3818663 |
| Address: | 6534 GUNN HWY, TAMPA, FL, 33625, US |
| Mail Address: | 6534 GUNN HWY, TAMPA, FL, 33625, US |
| ZIP code: | 33625 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1356905327 | 2019-04-25 | 2019-04-25 | 6534 GUNN HWY, TAMPA, FL, 336254022, US | 6534 GUNN HWY, TAMPA, FL, 336254022, US | |||||||||||||||||||||
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| Phone | +1 813-968-3500 |
| Fax | 8139683555 |
Authorized person
| Name | DR. LYNETTE BERVEN |
| Role | PRESIDENT |
| Phone | 8139683500 |
Taxonomy
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 003466000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BERVEN LYNETTE DR | Agent | 6534 GUNN HWY, TAMPA, FL, 33625 |
| Name | Role | Address |
|---|---|---|
| BERVEN LYNETTE DR | Manager | 6534 GUNN HWY, TAMPA, FL, 33625 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2021-02-23 |
| ANNUAL REPORT | 2020-06-08 |
| Florida Limited Liability | 2019-03-11 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
