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JOLEEN R. FERNALD PEDIATRIC THERAPY SERVICES, PLLC - Florida Company Profile

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Company Details

Entity Name: JOLEEN R. FERNALD PEDIATRIC THERAPY SERVICES, PLLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 15 May 2014 (11 years ago)
Document Number: L14000079447
FEI/EIN Number 46-5677776
Address: 2107 Gunn Hwy, Suite 106, Odessa, FL, 33556, US
Mail Address: 1820 Kinsmere Drive, Trinity, FL, 34655, US
ZIP code: 33556
City: Odessa
County: Hillsborough
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
FERNALD JOLEEN R Manager 1820 Kinsmere Drive, Trinity, FL, 34655
Bernhardt Lilibel Agent 18106 Glastonbury Lane, Land O Lakes, FL, 34638

National Provider Identifier

NPI Number:
1003540196
Certification Date:
2022-07-13

Authorized Person:

Name:
DR. JOLEEN FERNALD
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
224Z00000X - Occupational Therapy Assistant
Is Primary:
No
Selected Taxonomy:
225100000X - Physical Therapist
Is Primary:
No
Selected Taxonomy:
225200000X - Physical Therapy Assistant
Is Primary:
No
Selected Taxonomy:
225X00000X - Occupational Therapist
Is Primary:
No
Selected Taxonomy:
2355S0801X - Speech-Language Assistant
Is Primary:
No

Contacts:

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-02-10 2107 Gunn Hwy, Suite 106, Odessa, FL 33556 -
REGISTERED AGENT NAME CHANGED 2023-01-29 Bernhardt, Lilibel -
REGISTERED AGENT ADDRESS CHANGED 2023-01-29 18106 Glastonbury Lane, Land O Lakes, FL 34638 -
CHANGE OF MAILING ADDRESS 2020-02-08 2107 Gunn Hwy, Suite 106, Odessa, FL 33556 -

Documents

Name Date
ANNUAL REPORT 2025-02-07
ANNUAL REPORT 2024-02-10
ANNUAL REPORT 2023-01-29
ANNUAL REPORT 2022-02-02
ANNUAL REPORT 2021-02-25
ANNUAL REPORT 2020-02-08
ANNUAL REPORT 2019-02-10
ANNUAL REPORT 2018-02-16
ANNUAL REPORT 2017-02-07
ANNUAL REPORT 2016-04-13

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Date of last update: 03 Aug 2025

Sources: Florida Department of State