| Entity Name: | WESLEY CHAPEL SPINE & REHAB LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 25 Mar 2021 (4 years ago) |
| Document Number: | L21000140458 |
| FEI/EIN Number | 86-2845050 |
| Address: | 20433 BRUCE B DOWNS BLVD, TAMPA, FL 33647 |
| Mail Address: | 20433 BRUCE B DOWNS BLVD, TAMPA, FL 33647 |
| ZIP code: | 33647 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336721075 | 2021-04-22 | 2021-04-22 | 20433 BRUCE B DOWNS BLVD, TAMPA, FL, 336472759, US | 20433 BRUCE B DOWNS BLVD, TAMPA, FL, 336472759, US | |||||||||||||||||||||||||
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| Phone | +1 813-994-0151 |
Authorized person
| Name | DR. JASON M BROOKS |
| Role | OWNER |
| Phone | 8139940151 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| Is Primary | Yes |
| Taxonomy Code | 171100000X - Acupuncturist |
| Is Primary | No |
| Taxonomy Code | 2081S0010X - Sports Medicine (Physical Medicine & Rehabilitation) Physician |
| Is Primary | No |
| Taxonomy Code | 2251S0007X - Sports Physical Therapist |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| GO FIGURE ACCOUNTING | Agent | 855 E. PLANT STREET, SUITE 1600, WINTER GARDEN, FL 34787 |
| Name | Role | Address |
|---|---|---|
| BROOKS, JASON | Member | 20433 BRUCE B DOWNS BLVD, TAMPA, FL 33647 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000068708 | WESLEY CHAPEL SPINE & SPORTS MEDICINE | ACTIVE | 2021-05-20 | 2026-12-31 | No data | 20433 BRUCE B DOWNS BLVD, TAMPA, FL, 33647 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-31 |
| ANNUAL REPORT | 2023-02-01 |
| ANNUAL REPORT | 2022-02-07 |
| Florida Limited Liability | 2021-03-25 |
Date of last update: 14 Jan 2025
Sources: Florida Department of State
