| Entity Name: | PENSACOLA PHYSICAL MEDICINE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 30 Jul 2014 (11 years ago) |
| Document Number: | P14000063897 |
| FEI/EIN Number | 47-1461751 |
| Address: | 9007 UNIVERSITY PKWY., PENSACOLA, FL, 32514 |
| Mail Address: | 9007 UNIVERSITY PKWY., PENSACOLA, FL, 32514 |
| ZIP code: | 32514 |
| County: | Escambia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1629475033 | 2014-12-01 | 2015-10-05 | 9007 UNIVERSITY PKWY, PENSACOLA, FL, 325145525, US | 9007 UNIVERSITY PKWY, PENSACOLA, FL, 325145525, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 850-476-5420 |
| Fax | 8504765422 |
Authorized person
| Name | DR. PETER A SMITH |
| Role | PRESIDENT |
| Phone | 8504765420 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH 9119 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207RI0200X - Infectious Disease Physician |
| License Number | ME51367 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| License Number | ARNP9212528 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| SMITH PETER A | Agent | 9007 UNIVERSITY PKWY., PENSACOLA, FL, 32514 |
| Name | Role | Address |
|---|---|---|
| SMITH PETER A | President | 9007 UNIVERSITY PKWY., PENSACOLA, FL, 32514 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-20 |
| ANNUAL REPORT | 2024-04-04 |
| ANNUAL REPORT | 2023-03-04 |
| ANNUAL REPORT | 2022-03-09 |
| ANNUAL REPORT | 2021-02-08 |
| ANNUAL REPORT | 2020-01-29 |
| ANNUAL REPORT | 2019-02-06 |
| ANNUAL REPORT | 2018-01-15 |
| ANNUAL REPORT | 2017-03-15 |
| ANNUAL REPORT | 2016-03-09 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
