| Entity Name: | SHELBY D. OT SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 27 Jan 2014 (11 years ago) |
| Date of dissolution: | 30 Dec 2020 (4 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 30 Dec 2020 (4 years ago) |
| Document Number: | L14000014128 |
| FEI/EIN Number | 46-4644838 |
| Address: | 7451 WILES RD.,, SUITE 203, CORAL SPRINGS, FL 33067 |
| Mail Address: | 7451 WILES RD.,, SUITE 203, CORAL SPRINGS, FL 33067 |
| ZIP code: | 33067 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1760831127 | 2016-06-07 | 2019-07-31 | 7451 WILES RD STE 203, CORAL SPRINGS, FL, 330672040, US | 7451 WILES RD STE 203, CORAL SPRINGS, FL, 330672040, US | |||||||||||||||||||||||||
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| Phone | +1 954-906-5754 |
| Fax | 9542273566 |
Authorized person
| Name | SHELBY FEIERSTADT |
| Role | OWNER |
| Phone | 9549065754 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| Is Primary | No |
| Taxonomy Code | 225X00000X - Occupational Therapist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 017704000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FEIERSTADT, SHELBY | Agent | 1437 NW 102 DRIVE, CORAL SPRINGS, FL 33071 |
| Name | Role | Address |
|---|---|---|
| FEIERSTADT, SHELBY | Authorized Member | 1437 NW 102 DRIVE, CORAL SPRINGS, FL 33071 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000037181 | POSITIVE VIBES THERAPY | EXPIRED | 2016-04-12 | 2021-12-31 | No data | 1437 NW 102 DRIVE, CORAL SPRINGS, FL, 33071 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2020-12-30 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-08-16 | 7451 WILES RD.,, SUITE 203, CORAL SPRINGS, FL 33067 | No data |
| CHANGE OF MAILING ADDRESS | 2016-08-16 | 7451 WILES RD.,, SUITE 203, CORAL SPRINGS, FL 33067 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2020-12-30 |
| ANNUAL REPORT | 2020-01-22 |
| ANNUAL REPORT | 2019-04-07 |
| ANNUAL REPORT | 2018-01-23 |
| ANNUAL REPORT | 2017-01-12 |
| ANNUAL REPORT | 2016-03-02 |
| ANNUAL REPORT | 2015-01-18 |
| Florida Limited Liability | 2014-01-27 |
Date of last update: 21 Feb 2025
Sources: Florida Department of State
