| Entity Name: | INTERCOASTAL ORTHOTICS & PROSTHETICS LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
INTERCOASTAL ORTHOTICS & PROSTHETICS LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 15 Feb 2005 (20 years ago) |
| Date of dissolution: | 29 Apr 2012 (13 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 29 Apr 2012 (13 years ago) |
| Document Number: | L05000015772 |
| FEI/EIN Number |
331111676
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 1 PELICAN DR, EDGEWATER, FL, 32141, US |
| Mail Address: | 1 PELICAN DR, EDGEWATER, FL, 32141, US |
| ZIP code: | 32141 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1083839062 | 2007-04-16 | 2009-08-03 | 1 PELICAN DR STE A, EDGEWATER, FL, 321414254, US | 1 PELICAN DR STE A, EDGEWATER, FL, 321414254, US | |||||||||||||||||||||||||
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| Phone | +1 386-409-9432 |
| Fax | 3864099433 |
Authorized person
| Name | MR. TOM HARVEY MOWERY |
| Role | PROSTHETIST, ORTHOTIST |
| Phone | 3864099432 |
Taxonomy
| Taxonomy Code | 335E00000X - Prosthetic/Orthotic Supplier |
| License Number | POR 162 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS PROVIDER # |
| Number | M2714 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MOWERY TOM H | Manager | 3500 ROCK OAK TRAIL, EDGEWATER, FL, 32141 |
| MOWERY TOM H | Agent | 3500 ROCK OAK TRAIL, EDGEWATER, FL, 32141 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2012-04-29 | - | - |
| REGISTERED AGENT ADDRESS CHANGED | 2010-07-08 | 3500 ROCK OAK TRAIL, EDGEWATER, FL 32141 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2009-05-22 | 1 PELICAN DR, EDGEWATER, FL 32141 | - |
| CHANGE OF MAILING ADDRESS | 2009-05-22 | 1 PELICAN DR, EDGEWATER, FL 32141 | - |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2012-04-29 |
| ANNUAL REPORT | 2011-04-21 |
| ANNUAL REPORT | 2010-07-08 |
| ANNUAL REPORT | 2009-04-30 |
| ANNUAL REPORT | 2008-04-22 |
| ANNUAL REPORT | 2007-05-22 |
| ANNUAL REPORT | 2006-04-27 |
| Florida Limited Liability | 2005-02-15 |
Date of last update: 01 Apr 2025
Sources: Florida Department of State
