| Entity Name: | POTTER PHYSICAL THERAPY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 25 Jun 2021 (4 years ago) |
| Last Event: | LC NAME CHANGE |
| Event Date Filed: | 17 Nov 2022 (2 years ago) |
| Document Number: | L21000295080 |
| FEI/EIN Number | 87-1399247 |
| Address: | 5318 VAN DYKE ROAD, LUTZ, FL, 33558, US |
| Mail Address: | 19338 WIND DANCER ST, LUTZ, FL, 33558, US |
| ZIP code: | 33558 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1922670314 | 2021-07-14 | 2022-11-15 | 5318 VAN DYKE RD, LUTZ, FL, 335584829, US | 5318 VAN DYKE RD, LUTZ, FL, 335584829, US | |||||||||||||||||
|
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| Phone | +1 813-265-3033 |
| Fax | 8137277060 |
| Fax | 7273627060 |
Authorized person
| Name | ADRIANA NASCIMENTO POTTER |
| Role | PHYSICAL THERAPIST |
| Phone | 8132653033 |
Taxonomy
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| POTTER ADRIANA N | Agent | 19338 WIND DANCER ST, LUTZ, FL, 33558 |
| Name | Role | Address |
|---|---|---|
| POTTER ADRIANA N | Manager | 19338 WIND DANCER ST, LUTZ, FL, 33558 |
| Name | Role | Address |
|---|---|---|
| POTTER ROBERT E | Auth | 19338 WIND DANCER ST, LUTZ, FL, 33558 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC NAME CHANGE | 2022-11-17 | POTTER PHYSICAL THERAPY LLC | No data |
| LC AMENDMENT AND NAME CHANGE | 2021-07-12 | BENEFIT PHYSICAL THERAPY LLC | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-07-12 | 5318 VAN DYKE ROAD, LUTZ, FL 33558 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-04 |
| ANNUAL REPORT | 2023-02-16 |
| LC Name Change | 2022-11-17 |
| ANNUAL REPORT | 2022-01-27 |
| LC Amendment and Name Change | 2021-07-12 |
| Florida Limited Liability | 2021-06-25 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
