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PBISM WEST BOCA, INC. - Florida Company Profile

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Company Details

Entity Name: PBISM WEST BOCA, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 29 Apr 2019 (6 years ago)
Document Number: P19000037765
FEI/EIN Number 83-4682437
Mail Address: 515 N Flagler Drive, West Palm Beach, FL, 33401, US
Address: 21737 FL-7, BOCA RATON, FL, 33428, US
ZIP code: 33428
City: Boca Raton
County: Palm Beach
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
Tucker Jeffrey Manager 515 N Flagler Drive, West Palm Beach, FL, 33401
West Dylan Othe 515 N Flagler Drive, West Palm Beach, FL, 33401
Miller Ryan Agent 515 N Flagler Drive, West Palm Beach, FL, 33401

National Provider Identifier

NPI Number:
1053978353

Authorized Person:

Name:
BRAD VAN PELT
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
225100000X - Physical Therapist
Is Primary:
Yes

Contacts:

Fax:
5613312542

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G19000058641 PALM BEACH INSTITUTE OF SPORTS MEDICINE ACTIVE 2019-05-16 2029-12-31 - 3848 FAU BLVD, STE 105, BOCA RATON, FL, 33431

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2025-07-01 21737 FL-7, BOCA RATON, FL 33428 -
CHANGE OF MAILING ADDRESS 2025-02-10 21737 FL-7, BOCA RATON, FL 33428 -
REGISTERED AGENT NAME CHANGED 2025-02-10 Miller, Ryan -
REGISTERED AGENT ADDRESS CHANGED 2025-02-10 515 N Flagler Drive, Suite 1500, West Palm Beach, FL 33401 -
CHANGE OF PRINCIPAL ADDRESS 2024-07-01 21737 FL-7, BOCA RATON, FL 33428 -

Documents

Name Date
ANNUAL REPORT 2025-02-10
ANNUAL REPORT 2024-01-30
ANNUAL REPORT 2023-01-25
ANNUAL REPORT 2022-01-24
ANNUAL REPORT 2021-01-11
ANNUAL REPORT 2020-01-20
Domestic Profit 2019-04-29

USAspending Awards / Financial Assistance

Date:
2020-04-30
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
26400.00
Total Face Value Of Loan:
26400.00

Paycheck Protection Program

Jobs Reported:
4
Initial Approval Amount:
$26,400
Date Approved:
2020-04-30
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$26,400
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$26,596.73
Servicing Lender:
Seacoast National Bank
Use of Proceeds:
Payroll: $26,400

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Date of last update: 02 Aug 2025

Sources: Florida Department of State