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PHYSICIANS SERVICES PHYSIOTHERAPY & WELLNESS CENTER LLC - Florida Company Profile

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Company Details

Entity Name: PHYSICIANS SERVICES PHYSIOTHERAPY & WELLNESS CENTER LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 05 Mar 2024 (a year ago)
Document Number: L24000112929
FEI/EIN Number 99-1047903
Address: 500 VONDERBERG DR, SUITE #105, BRANDON, FL, 33511
Mail Address: PO. BOX 846, RIVERVIEW, FL, 33568
ZIP code: 33511
City: Brandon
County: Hillsborough
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
BENTON KEVIN C Manager PO BOX 846, RIVERVIEW, FL, 33568
BENTON VANESSA N Manager PO BOX 846, RIVERVIEW, FL, 33568
BENTON KEVIN C Agent 11305 LANGWORTH HILL LANE, RIVERVIEW, FL, 33579

National Provider Identifier

NPI Number:
1063279479
Certification Date:
2024-03-01

Authorized Person:

Name:
KEVIN C BENTON
Role:
CEO
Phone:

Taxonomy:

Selected Taxonomy:
111NR0400X - Rehabilitation Chiropractor
Is Primary:
Yes

Contacts:

Documents

Name Date
Florida Limited Liability 2024-03-05

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Date of last update: 03 Aug 2025

Sources: Florida Department of State