| Entity Name: | CENTRAL FLORIDA DREAMPLEX, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 23 Sep 2013 (11 years ago) |
| Document Number: | L13000134244 |
| FEI/EIN Number | 46-3870058 |
| Address: | 2400 S. Hwy 27, Suite B201, Clermont, FL 34711 |
| Mail Address: | PO Box 120547, Clermont, FL 34712 |
| ZIP code: | 34711 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1457526378 | 2008-04-23 | 2020-03-26 | PO BOX 120547, CLERMONT, FL, 347120547, US | 2400 S HIGHWAY 27 STE B201, CLERMONT, FL, 347116816, US | |||||||||||||||||||||
|
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| Phone | +1 352-394-0212 |
| Fax | 3522416361 |
Authorized person
| Name | AMY JO GOMES |
| Role | PRESIDENT |
| Phone | 3524060922 |
Taxonomy
| Taxonomy Code | 222Q00000X - Developmental Therapist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 811908200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GOMES, AMY J | Agent | 2400 S. Hwy 27, Suite B201, Clermont, FL 34711 |
| Name | Role | Address |
|---|---|---|
| GOMES, AMY | Manager | 12118 Cypress Ln, CLERMONT, FL 34711 |
| GOMES, CAMERON | Manager | 12118 Cypress Ln, Clermont, FL 34711 |
| Nethero, Amanda | Manager | 2400 S. Hwy 27, Suite B201 Clermont, FL 34711 |
| Smith, Marla | Manager | 2400 S. Hwy 27, Suite B201 Clermont, FL 34711 |
| Moore, Blake | Manager | 2400 S. Hwy 27, Suite B201 Clermont, FL 34711 |
| Saunders, Susan | Manager | 2400 S. Hwy 27, Suite B201 Clermont, FL 34711 |
| McNiel, Shawn | Manager | 2400 S. Hwy 27, Suite B201 Clermont, FL 34711 |
| Haase, Bruce | Manager | 2400 S. Hwy 27, Suite B201 Clermont, FL 34711 |
| Robinson, Lianne | Manager | 2400 S. Hwy 27, Suite B201 Clermont, FL 34711 |
| Calloway, Kristy | Manager | 2400 S. Hwy 27, Suite B201 Clermont, FL 34711 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000030090 | THE FRIENDSHIP PLACE | ACTIVE | 2023-03-06 | 2028-12-31 | No data | PO BOX 120547, CLERMONT, FL, 34712 |
| G19000071386 | DREAMPLEX THERAPEUTIC SCHOOL | EXPIRED | 2019-06-26 | 2024-12-31 | No data | PO BOX 120547, CLERMONT, FL, 34712 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-01-24 | 2400 S. Hwy 27, Suite B201, Clermont, FL 34711 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-04-08 | 2400 S. Hwy 27, Suite B201, Clermont, FL 34711 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-04-08 | 2400 S. Hwy 27, Suite B201, Clermont, FL 34711 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-24 |
| ANNUAL REPORT | 2023-01-10 |
| ANNUAL REPORT | 2022-01-26 |
| ANNUAL REPORT | 2021-02-01 |
| ANNUAL REPORT | 2020-01-20 |
| ANNUAL REPORT | 2019-02-04 |
| ANNUAL REPORT | 2018-01-17 |
| ANNUAL REPORT | 2017-01-27 |
| ANNUAL REPORT | 2016-03-29 |
| ANNUAL REPORT | 2015-04-08 |
Date of last update: 22 Jan 2025
Sources: Florida Department of State
