| Entity Name: | THERAPEUTIC INTERVENTIONS OF WEST FLORIDA, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 05 Jan 2004 (21 years ago) |
| Document Number: | P04000003967 |
| FEI/EIN Number | 200563924 |
| Address: | 2007 DODGE STREET, CLEARWATER, FL, 33760, UN |
| Mail Address: | 2007 DODGE STREET, CLEARWATER, FL, 33760, UN |
| ZIP code: | 33760 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1831219849 | 2007-03-31 | 2018-07-17 | 2007 DODGE ST, CLEARWATER, FL, 337601814, US | 4760 E BAY DR STE D, CLEARWATER, FL, 33764, US | |||||||||||||||||||||||||
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| Phone | +1 727-481-1694 |
| Fax | 7274747985 |
Authorized person
| Name | KATHERYN GONZALEZ |
| Role | PRESIDENT |
| Phone | 7274811694 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| License Number | PT0012196 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 020381600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GONZALEZ KATHERYN | Agent | 2007 DODGE STREET, CLEARWATER, FL, 33760 |
| Name | Role | Address |
|---|---|---|
| GONZALEZ KATHERYN A | President | 2007 DODGE STREET, CLEARWATER, FL, 33760 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000012859 | KINESIS THE MOVEMENT STUDIO | ACTIVE | 2018-01-23 | 2028-12-31 | No data | 2007 DODGE ST, CLEARWATER, FL, 33760 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2012-01-08 | 2007 DODGE STREET, CLEARWATER, FL 33760 UN | No data |
| CHANGE OF MAILING ADDRESS | 2012-01-08 | 2007 DODGE STREET, CLEARWATER, FL 33760 UN | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-06 |
| ANNUAL REPORT | 2023-01-18 |
| ANNUAL REPORT | 2022-01-07 |
| ANNUAL REPORT | 2021-01-16 |
| ANNUAL REPORT | 2020-01-18 |
| ANNUAL REPORT | 2019-02-07 |
| ANNUAL REPORT | 2018-01-23 |
| ANNUAL REPORT | 2017-01-07 |
| ANNUAL REPORT | 2016-03-07 |
| ANNUAL REPORT | 2015-01-04 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
