| Entity Name: | TAMPA KIDS THERAPY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 08 Jan 2014 (11 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 10 Mar 2014 (11 years ago) |
| Document Number: | L14000003837 |
| FEI/EIN Number | 59-4200102 |
| Address: | 3801 S Manhattan Ave, TAMPA, FL, 33629, US |
| Mail Address: | 3603 W GRANADA ST, TAMPA, FL, 33629, US |
| ZIP code: | 33629 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1841647112 | 2016-05-17 | 2016-05-17 | 3603 W GRANADA ST, TAMPA, FL, 336296917, US | 3401 S MACDILL AVE, TAMPA, FL, 336298896, US | |||||||||||||||||||||||
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| Phone | +1 813-399-0722 |
Authorized person
| Name | KRISTEN HUMPHREY |
| Role | OCCUPATIONAL THERAPIST |
| Phone | 3863168400 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| License Number | 17239 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 5151 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| KERSTING LORI | Agent | 3603 W GRANADA ST, TAMPA, FL, 33629 |
| Name | Role | Address |
|---|---|---|
| KERSTING LORI | Authorized Member | 3603 W GRANADA ST, TAMPA, FL, 33629 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-01-07 | 3801 S Manhattan Ave, TAMPA, FL 33629 | No data |
| LC AMENDMENT | 2014-03-10 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-26 |
| ANNUAL REPORT | 2023-03-07 |
| ANNUAL REPORT | 2022-01-23 |
| ANNUAL REPORT | 2021-01-07 |
| ANNUAL REPORT | 2020-07-18 |
| ANNUAL REPORT | 2019-02-07 |
| ANNUAL REPORT | 2018-01-14 |
| ANNUAL REPORT | 2017-02-08 |
| ANNUAL REPORT | 2016-02-27 |
| ANNUAL REPORT | 2015-01-02 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
