| Entity Name: | COAST 2 COAST SPORTS MEDICINE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 11 Oct 2023 (a year ago) |
| Document Number: | L23000467931 |
| FEI/EIN Number | 93-3829354 |
| Address: | 5300 POWERLINE RD C/O XPE SPORTS, FORT LAUDERDALE, FL 33309 |
| Mail Address: | 5300 POWERLINE RD C/O XPE SPORTS, FORT LAUDERDALE, FL 33309 |
| ZIP code: | 33309 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245007665 | 2023-12-06 | 2023-12-06 | 430 OXFORD DR, ARCADIA, CA, 910072643, US | 5300 POWERLINE RD, FORT LAUDERDALE, FL, 333093172, US | |||||||||||||
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| Phone | +1 626-241-5134 |
Authorized person
| Name | KRISTIAN SALAZAR |
| Role | OWNER / PHYSICAL THERAPIST |
| Phone | 6262415134 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| INC AUTHORITY RA | Agent | 390 NORTH ORANGE AVE., STE 2300-N, ORLANDO, FL 32801 |
| Name | Role | Address |
|---|---|---|
| NOGUCHI-SALAZAR, KRISTIAN | Manager | 5300 POWERLINE RD C/O XPE SPORTS, FORT LAUDERDALE, FL 33309 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000149039 | XPE SPORTS REHABILITATION | ACTIVE | 2023-12-08 | 2028-12-31 | No data | 5300 POWERLINE RD C/O XPE SPORTS, FORT LAUDERDALE, FL, 33309 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-22 |
| Florida Limited Liability | 2023-10-11 |
Date of last update: 09 Feb 2025
Sources: Florida Department of State
