| Entity Name: | TRUST ORTHOPEDIC AND SPORTS REHAB LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 03 Feb 2021 (4 years ago) |
| Document Number: | L21000059600 |
| FEI/EIN Number | 86-2397469 |
| Address: | 29251 US HIGHWAY 19 NORTH, CLEARWATER, FL 33761 |
| Mail Address: | 29251 US HIGHWAY 19 NORTH, CLEARWATER, FL 33761 |
| ZIP code: | 33761 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1104408533 | 2021-04-26 | 2021-09-08 | 29251 US HIGHWAY 19 N, CLEARWATER, FL, 337612102, US | 29251 US HIGHWAY 19 N, CLEARWATER, FL, 337612102, US | |||||||||||||||||||||||||
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| Phone | +1 727-953-3031 |
| Fax | 7272641542 |
Authorized person
| Name | MINA MALAK KHALIL SHEHATA |
| Role | OWNER |
| Phone | 7279533031 |
Taxonomy
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| Is Primary | No |
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | FLORIDA LICENSE |
| Number | 32409 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SHEHATA, MINA M | Agent | 29251 US HIGHWAY 19 NORTH, CLEARWATER, FL 33761 |
| Name | Role | Address |
|---|---|---|
| SHEHATA, MINA M | Authorized Member | 29251 US HIGHWAY 19 NORTH, CLEARWATER, FL 33761 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000035143 | TRUST PHYSICAL THERAPY | ACTIVE | 2021-03-12 | 2026-12-31 | No data | 3163 STERLING ST, TARPON SPRINGS, FL, 34688 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2023-04-14 | 29251 US HIGHWAY 19 NORTH, CLEARWATER, FL 33761 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-14 | 29251 US HIGHWAY 19 NORTH, CLEARWATER, FL 33761 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-02-11 |
| ANNUAL REPORT | 2024-04-02 |
| ANNUAL REPORT | 2023-04-14 |
| ANNUAL REPORT | 2022-04-12 |
| Florida Limited Liability | 2021-02-03 |
Date of last update: 14 Feb 2025
Sources: Florida Department of State
