| Entity Name: | SYSTEMIC INNOVATIONS LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 14 Apr 2014 (11 years ago) |
| Date of dissolution: | 25 Sep 2015 (9 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2015 (9 years ago) |
| Document Number: | L14000061164 |
| Address: | 406 LAKE HOWELL BRANCH RD, MAITLAND, FL, 32751, US |
| Mail Address: | 406 LAKE HOWELL BRANCH RD, MAITLAND, FL, 32751, US |
| ZIP code: | 32751 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1568872372 | 2014-05-01 | 2014-06-04 | 406 LAKE HOWELL RD, MAITLAND, FL, 327515907, US | 406 LAKE HOWELL RD, MAITLAND, FL, 327515907, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 407-691-3960 |
| Fax | 4076913961 |
Authorized person
| Name | JULIE D EBERWEIN |
| Role | OWNER |
| Phone | 4076913960 |
Taxonomy
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| License Number | MH9903 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 001116400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| EBERWEIN JULIE D | Agent | 406 LAKE HOWELL BRANCH RD, MAITLAND, FL, 32751 |
| Name | Role | Address |
|---|---|---|
| EBERWEIN JULIE D | Manager | 406 LAKE HOWELL BRANCH RD, MAITLAND, FL, 32751 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| Name | Date |
|---|---|
| Florida Limited Liability | 2014-04-14 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
