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PHYSICAL THERAPY SERVICES OF BROOKSVILLE, INC.

Company Details

Entity Name: PHYSICAL THERAPY SERVICES OF BROOKSVILLE, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 27 Nov 1991 (33 years ago)
Document Number: S97266
FEI/EIN Number 593096501
Address: 20195 CORTEZ BLVD., BROOKSVILLE, FL, 34601, US
Mail Address: 20195 CORTEZ BLVD., BROOKSVILLE, FL, 34601, US
ZIP code: 34601
County: Hernando
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1275506305 2006-02-09 2008-02-06 20195 CORTEZ BLVD, BROOKSVILLE, FL, 346013850, US 20195 CORTEZ BLVD, BROOKSVILLE, FL, 346013850, US

Contacts

Phone +1 352-754-4500
Fax 3527549343

Authorized person

Name MR. KELLY RICE
Role PRESIDENT
Phone 3527544500

Taxonomy

Taxonomy Code 225100000X - Physical Therapist
Is Primary Yes

Agent

Name Role Address
RICE KELLY S Agent 1928 C 478A, WEBSTER, FL, 33585

Director

Name Role Address
RICE KELLY S Director 1928 C 478A, WEBSTER, FL, 33585
RICE KATHERINE M Director 1928 C 478A, WEBSTER, FL, 33585

President

Name Role Address
RICE KELLY S President 1928 C 478A, WEBSTER, FL, 33585

Vice President

Name Role Address
RICE KATHERINE M Vice President 1928 C 478A, WEBSTER, FL, 33585

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G24000062679 PHYSICAL THERAPY SERVICES OF SUMTER ACTIVE 2024-05-14 2029-12-31 No data WEST OAKS CENTER, 413 N WEST STREET, BUSHNELL, FL, 33513
G11000029540 PHYSICAL THERAPY SERVICES OF SPRING HILL ACTIVE 2011-03-23 2026-12-31 No data 20195 CORTEZ BLVD., BROOKSVILLE, FL, 34601

Date of last update: 02 Feb 2025

Sources: Florida Department of State