| Entity Name: | BREVARD PHYSICAL THERAPY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 19 Sep 2022 (2 years ago) |
| Document Number: | L22000408060 |
| FEI/EIN Number | 92-0423641 |
| Address: | 7756 MANGO GROVE AVENUE, MELBOURNE, FL 32904 |
| Mail Address: | 7756 MANGO GROVE AVENUE, MELBOURNE, FL 32904 |
| ZIP code: | 32904 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1417671645 | 2022-09-30 | 2022-09-30 | 7756 MANGO GROVE AVE, MELBOURNE, FL, 329042133, US | 7756 MANGO GROVE AVE, MELBOURNE, FL, 329042133, US | |||||||||||||||
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| Phone | +1 321-848-1893 |
| Phone | +1 321-848-7695 |
Authorized person
| Name | ERIK NELSON |
| Role | OWNER |
| Phone | 3218487695 |
Taxonomy
| Taxonomy Code | 2251G0304X - Geriatric Physical Therapist |
| Is Primary | Yes |
| Name | Role |
|---|---|
| ZENBUSINESS INC. | Agent |
| Name | Role | Address |
|---|---|---|
| NELSON, ERIK | Authorized Member | 7756 MANGO GROVE AVENUE, MELBOURNE, FL 32904 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-02 |
| ANNUAL REPORT | 2023-01-31 |
| Florida Limited Liability | 2022-09-19 |
Date of last update: 11 Feb 2025
Sources: Florida Department of State
