| Entity Name: | PIVOTAL PHYSICAL THERAPY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 14 Apr 2023 (2 years ago) |
| Document Number: | L23000184916 |
| FEI/EIN Number | 92-3526283 |
| Address: | 1106 CRANE COVE BOULEVARD, GULF BREEZE, FL, 32563, UN |
| Mail Address: | 1106 CRANE COVE BOULEVARD, GULF BREEZE, FL, 32563, UN |
| ZIP code: | 32563 |
| County: | Santa Rosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1861188344 | 2023-04-17 | 2023-04-17 | 1106 CRANE COVE BLVD, GULF BREEZE, FL, 325633190, US | 1106 CRANE COVE BLVD, GULF BREEZE, FL, 325633190, US | |||||||||||||
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| Phone | +1 850-207-5874 |
Authorized person
| Name | NICHOLAS TREVINO |
| Role | OWNER |
| Phone | 8502075874 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| TREVINO NICHOLAS V | Agent | 1106 CRANE COVE BOULEVARD, GULF BREEZE, FL, 32563 |
| Name | Role | Address |
|---|---|---|
| TREVINO NICHOLAS V | Authorized Person | 1106 CRANE COVE BOULEVARD, GULF BREEZE, FL, 32563 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-01 |
| Florida Limited Liability | 2023-04-14 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
