| Entity Name: | DR. ANTHONY S. CAPOZZI, LLC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 08 Dec 2011 (13 years ago) |
| Date of dissolution: | 20 Mar 2024 (a year ago) |
| Last Event: | LC VOLUNTARY DISSOLUTION |
| Event Date Filed: | 20 Mar 2024 (a year ago) |
| Document Number: | L11000139256 |
| FEI/EIN Number | 453935717 |
| Address: | 1730 Dunlawton Avenue, Suite 2, Port Orange, FL, 32127, US |
| Mail Address: | 1730 Dunlawton Avenue, Suite 2, Port Orange, FL, 32127, US |
| ZIP code: | 32127 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063761427 | 2012-08-31 | 2022-05-24 | 136 JULIA ST UNIT 100, NEW SMYRNA BEACH, FL, 321687713, US | 1730 DUNLAWTON AVE STE 3, PORT ORANGE, FL, 321278986, US | |||||||||||||||||||||||||||
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| Phone | +1 386-423-9161 |
| Fax | 3864233094 |
| Phone | +1 386-957-3905 |
Authorized person
| Name | DR. ANTHONY CAPOZZI |
| Role | OWNER |
| Phone | 3869573905 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| License Number | ME105803 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PTAN |
| Number | EP827Z |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR ANTHONY S CAPOZZI 401K | 2023 | 453935717 | 2024-12-17 | DR ANTHONY S CAPOZZI LLC | 1 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-12-17 |
| Name of individual signing | SHIRLEY HORNER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-08-01 |
| Business code | 621112 |
| Sponsor’s telephone number | 3868684445 |
| Plan sponsor’s address | 6831 VINTAGE LANE, PORT ORANGE, FL, 32128 |
Signature of
| Role | Plan administrator |
| Date | 2024-07-11 |
| Name of individual signing | NICK RICE |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-08-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 3868684445 |
| Plan sponsor’s address | 1730 DUNLAWTON AVE, STE 2, PORT ORANGE, FL, 32127 |
Signature of
| Role | Plan administrator |
| Date | 2023-07-19 |
| Name of individual signing | SHIRLEY HORNER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| Capozzi Anthony | Agent | 1730 Dunlawton Avenue, Port Orange, FL, 32127 |
| Name | Role | Address |
|---|---|---|
| CAPOZZI ANTHONY | Manager | 1730 Dunlawton Avenue, Port Orange, FL, 32127 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000132881 | ADVANCED TMS OF PORT ORANGE | ACTIVE | 2022-10-25 | 2027-12-31 | No data | 1730 DUNLAWTON AVENUE STE 2, PORT ORANGE, FL, 32127 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC VOLUNTARY DISSOLUTION | 2024-03-20 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-02-07 | 1730 Dunlawton Avenue, Suite 2, Port Orange, FL 32127 | No data |
| CHANGE OF MAILING ADDRESS | 2023-02-07 | 1730 Dunlawton Avenue, Suite 2, Port Orange, FL 32127 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-02-07 | 1730 Dunlawton Avenue, Suite 2, Port Orange, FL 32127 | No data |
| REGISTERED AGENT NAME CHANGED | 2021-04-02 | Capozzi, Anthony | No data |
| Name | Date |
|---|---|
| LC Voluntary Dissolution | 2024-03-20 |
| ANNUAL REPORT | 2023-02-07 |
| ANNUAL REPORT | 2022-04-05 |
| ANNUAL REPORT | 2021-04-02 |
| ANNUAL REPORT | 2020-01-02 |
| ANNUAL REPORT | 2019-01-19 |
| ANNUAL REPORT | 2018-01-10 |
| ANNUAL REPORT | 2017-01-05 |
| ANNUAL REPORT | 2016-01-07 |
| ANNUAL REPORT | 2015-02-22 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
