| Entity Name: | PRO VITA PHYSICAL THERAPY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 19 Jun 2019 (6 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 22 Oct 2019 (5 years ago) |
| Document Number: | L19000161709 |
| FEI/EIN Number | 84-2266437 |
| Address: | 638 N. Ferdon Blvd, CRESTVIEW, FL, 32536, US |
| Mail Address: | 3367 Citrine Circle, CRESTVIEW, FL, 32536, US |
| ZIP code: | 32536 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| Type | Company Name | Company Number | State |
|---|---|---|---|
| Headquarter of | PRO VITA PHYSICAL THERAPY, LLC, ALABAMA | 001-093-535 | ALABAMA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245945807 | 2023-01-18 | 2023-01-18 | 638 N FERDON BLVD STE 1, CRESTVIEW, FL, 325362170, US | 5941 BERRYHILL RD STE I, MILTON, FL, 325704043, US | |||||||||||||||||
|
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| Phone | +1 850-331-3017 |
| Fax | 8552752575 |
| Fax | 8555952306 |
Authorized person
| Name | MRS. CARLA J BULLA |
| Role | OWNER |
| Phone | 8503313017 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BULLA CARLA J | Agent | 638 N Ferdon Blvd, CRESTVIEW, FL, 32536 |
| Name | Role | Address |
|---|---|---|
| BULLA CARLA | Authorized Member | 638 N Ferdon Blvd, CRESTVIEW, FL, 32536 |
| Name | Role | Address |
|---|---|---|
| Estes Ulysses | Auth | 638 N Ferdon Blvd, CRESTVIEW, FL, 32536 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-06 | 638 N. Ferdon Blvd, CRESTVIEW, FL 32536 | No data |
| CHANGE OF MAILING ADDRESS | 2024-03-06 | 638 N. Ferdon Blvd, CRESTVIEW, FL 32536 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-02-28 | 638 N Ferdon Blvd, Ste 1, CRESTVIEW, FL 32536 | No data |
| LC AMENDMENT | 2019-10-22 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-06 |
| ANNUAL REPORT | 2023-02-28 |
| ANNUAL REPORT | 2022-01-26 |
| ANNUAL REPORT | 2021-04-06 |
| ANNUAL REPORT | 2020-01-24 |
| LC Amendment | 2019-10-22 |
| Florida Limited Liability | 2019-06-19 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
