| Entity Name: | PEDIATRIC THERAPY SERVICES OF GREATER ORLANDO, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 29 Nov 2004 (20 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 05 Oct 2023 (a year ago) |
| Document Number: | L04000088496 |
| FEI/EIN Number | 201990437 |
| Address: | 301 SW CROWN POINT BLVD., SUITE 150, WINTER GARDEN, FL, 34787, US |
| Mail Address: | 5036 DR.PHILLIPS BLVD, #364, ORLANDO, FL, 32819 |
| ZIP code: | 34787 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013926187 | 2006-08-06 | 2024-06-13 | 5036 DR. PHILIPS BLVD., SUITE 364, ORLANDO, FL, 328193319, US | 301 S WEST CROWN POINTE RD, SUITE 150, WINTER GARDEN, FL, 34787, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Phone | +1 407-491-3825 |
| Fax | 4079058958 |
| Phone | +1 407-905-8905 |
Authorized person
| Name | MRS. TONYA LORENE CARSON |
| Role | OWNER |
| Phone | 4074913825 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| License Number | PT19866 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 225100000X - Physical Therapist |
| License Number | PT7810 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 225X00000X - Occupational Therapist |
| License Number | OT-499 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 235Z00000X - Speech-Language Pathologist |
| License Number | SA7850 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 235Z00000X - Speech-Language Pathologist |
| License Number | SA6784 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 120013700 |
| State | FL |
| Issuer | MEDICAID |
| Number | 890158900 |
| State | FL |
| Issuer | MEDICAID |
| Number | 812291100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CARSON TONYA | Agent | 301 SW CROWN POINT BLVD., SUITE 150, WINTER GARDEN, FL, 34787 |
| Name | Role | Address |
|---|---|---|
| PARIKH BHAVINI | Manager | 434 ANESSA ROSE LOOP, OCOEE, FL, 34761 |
| MILIAN SHAKIRA | Manager | 10457 CYPRESS TRAIL DRIVE, ORLANDO, FL, 32825 |
| CARSON TONYA | Manager | 12812 KEDLLESTONE LANE, WINTER GARDEN, FL, 34787 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2023-10-05 | 301 SW CROWN POINT BLVD., SUITE 150, WINTER GARDEN, FL 34787 | No data |
| LC AMENDMENT | 2023-10-05 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-10-05 | 301 SW CROWN POINT BLVD., SUITE 150, WINTER GARDEN, FL 34787 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-10-05 | CARSON, TONYA | No data |
| REINSTATEMENT | 2013-01-11 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| REINSTATEMENT | 2011-10-07 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2005-03-14 | 301 SW CROWN POINT BLVD., SUITE 150, WINTER GARDEN, FL 34787 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-07 |
| LC Amendment | 2023-10-05 |
| ANNUAL REPORT | 2023-02-06 |
| ANNUAL REPORT | 2022-01-21 |
| ANNUAL REPORT | 2021-01-31 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-01-14 |
| ANNUAL REPORT | 2018-01-25 |
| ANNUAL REPORT | 2017-03-28 |
| ANNUAL REPORT | 2016-04-29 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
