| Entity Name: | ACE THERAPY GROUP, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 09 May 2011 (14 years ago) |
| Document Number: | L11000054321 |
| FEI/EIN Number | 452417297 |
| Address: | 148 River Plantation Rd N, St Augustine, FL, 32092, US |
| Mail Address: | 148 River Plantation Rd N, St Augustine, FL, 32092, US |
| ZIP code: | 32092 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1649565284 | 2011-06-11 | 2016-07-23 | 21929 CRICKLEWOOD TER, BOCA RATON, FL, 334283053, US | 21929 CRICKLEWOOD TER, BOCA RATON, FL, 334283053, US | |||||||||||||||||||||||||
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| Phone | +1 954-298-7591 |
| Fax | 5612886000 |
Authorized person
| Name | AMY ETKIE |
| Role | SPEECH PATHOLOGIST |
| Phone | 9542987591 |
Taxonomy
| Taxonomy Code | 235Z00000X - Speech-Language Pathologist |
| License Number | SA 10046 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 000394400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ETKIE DANIEL | Agent | 148 River Plantation Rd N, St Augustine, FL, 32092 |
| Name | Role | Address |
|---|---|---|
| ETKIE DANIEL | Managing Member | 148 River Plantation Rd N, St Augustine, FL, 32092 |
| ETKIE AMY | Managing Member | 148 River Plantation Rd N, St Augustine, FL, 32092 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-01 | 148 River Plantation Rd N, St Augustine, FL 32092 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-01 | 148 River Plantation Rd N, St Augustine, FL 32092 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-01 | 148 River Plantation Rd N, St Augustine, FL 32092 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-01 |
| ANNUAL REPORT | 2023-03-31 |
| ANNUAL REPORT | 2022-02-18 |
| ANNUAL REPORT | 2021-04-03 |
| ANNUAL REPORT | 2020-01-16 |
| ANNUAL REPORT | 2019-04-11 |
| ANNUAL REPORT | 2018-04-06 |
| ANNUAL REPORT | 2017-03-19 |
| ANNUAL REPORT | 2016-01-27 |
| ANNUAL REPORT | 2015-01-11 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
