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TRIDENT SPORTS MEDICINE AND REHABILITATION INC. - Florida Company Profile

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Company Details

Entity Name: TRIDENT SPORTS MEDICINE AND REHABILITATION INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 20 Dec 2023 (2 years ago)
Document Number: P23000086932
FEI/EIN Number 93-4946965
Mail Address: 873 Hull Rd, Ormond Beach, FL, 32174, US
Address: 873 HULL RD, ORMOND BEACH, FL, 32174, US
ZIP code: 32174
City: Ormond Beach
County: Volusia
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
LYNCH MICHAEL F President 62 SANDCASTLE DR, ORMOND BEACH, FL, 32176
FULTON BRENT N Vice President 195 WINDWARD LN, ORMOND BEACH, FL, 32176
LYNCH MICHAEL F Agent 62 SANDCASTLE DR, ORMOND BEACH, FL, 32176

U.S. Small Business Administration Profile

Phone Number:
E-mail Address:
Contact Person:
MICHAEL LYNCH
Ownership and Self-Certifications:
Self-Certified Small Disadvantaged Business, Service-Disabled Veteran, Veteran
User ID:
P3233332

Unique Entity ID

Unique Entity ID:
ZXQ8J9M4JWZ5
CAGE Code:
9T4B4
UEI Expiration Date:
2026-02-07

Business Information

Activation Date:
2025-02-11
Initial Registration Date:
2024-02-04

Commercial and government entity program

CAGE number:
9T4B4
Status:
Active
Type:
Non-Manufacturer
CAGE Update Date:
2025-02-11
CAGE Expiration:
2030-02-11
SAM Expiration:
2026-02-07

Contact Information

POC:
MICHAEL F. LYNCH

National Provider Identifier

NPI Number:
1811766637
Certification Date:
2024-05-08

Authorized Person:

Name:
MICHAEL F LYNCH
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
261QH0700X - Hearing and Speech Clinic/Center
Is Primary:
No
Selected Taxonomy:
261QP2000X - Physical Therapy Clinic/Center
Is Primary:
No
Selected Taxonomy:
207QS0010X - Sports Medicine (Family Medicine) Physician
Is Primary:
Yes

Contacts:

Fax:
3866036007

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2024-12-10 3127 W INTERNATIONAL SPEEDWAY BLVD, DAYTONA BEACH, FL 32124 -

Documents

Name Date
Domestic Profit 2023-12-20

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Date of last update: 01 Aug 2025

Sources: Florida Department of State