| Entity Name: | POTENTIAL PEDIATRIC OCCUPATIONAL THERAPY SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
POTENTIAL PEDIATRIC OCCUPATIONAL THERAPY SERVICES, 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: | 16 Jun 2010 (15 years ago) |
| Date of dissolution: | 29 Apr 2015 (10 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 29 Apr 2015 (10 years ago) |
| Document Number: | L10000064214 |
| FEI/EIN Number |
272884257
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 345 Captiva Dr, Ponte Vedra, FL, 32081, US |
| Mail Address: | 345 Captiva Dr, Ponte Vedra, FL, 32081, US |
| ZIP code: | 32081 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1619216215 | 2013-02-04 | 2013-02-04 | 10161 BROOKWOOD FOREST BLVD, JACKSONVILLE, FL, 322259064, US | 10161 BROOKWOOD FOREST BLVD, JACKSONVILLE, FL, 322259064, US | |||||||||||||||||||||||||
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| Phone | +1 904-254-7569 |
| Fax | 9043026270 |
Authorized person
| Name | MARY HUSZCZA |
| Role | OWNER |
| Phone | 9042547569 |
Taxonomy
| Taxonomy Code | 225X00000X - Occupational Therapist |
| License Number | OT10154 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 887015200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HUSZCZA MARY D | Managing Member | 345 Captiva Dr, Ponte Vedra, FL, 32081 |
| HUSZCZA MARY D | Agent | 345 Captiva Dr, Ponte Vedra, FL, 32081 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2015-04-29 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2013-04-30 | 345 Captiva Dr, Ponte Vedra, FL 32081 | - |
| CHANGE OF MAILING ADDRESS | 2013-04-30 | 345 Captiva Dr, Ponte Vedra, FL 32081 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2013-04-30 | 345 Captiva Dr, Ponte Vedra, FL 32081 | - |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2015-04-29 |
| ANNUAL REPORT | 2014-04-28 |
| ANNUAL REPORT | 2013-04-30 |
| ANNUAL REPORT | 2012-03-21 |
| ANNUAL REPORT | 2011-03-09 |
| Florida Limited Liability | 2010-06-16 |
Date of last update: 02 Mar 2025
Sources: Florida Department of State
