| Entity Name: | AUTISM SOLUTIONS OF TAMPA BAY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 27 Aug 2014 (10 years ago) |
| Date of dissolution: | 22 Sep 2017 (7 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2017 (7 years ago) |
| Document Number: | L14000134355 |
| FEI/EIN Number | 47-1695547 |
| Address: | 2905 MOSSY TIMBER TRAIL, VALRICO, FL, 33596 |
| Mail Address: | 2905 MOSSY TIMBER TRAIL, VALRICO, FL, 33596 |
| ZIP code: | 33596 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1578963120 | 2014-09-02 | 2016-05-23 | 2905 MOSSY TIMBER TRL, VALRICO, FL, 335967949, US | 2905 MOSSY TIMBER TRL, VALRICO, FL, 335967949, US | |||||||||||||||||||||||||||||||
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| Phone | +1 813-643-9669 |
Authorized person
| Name | MR. ANTHONY R PAWLISZ |
| Role | CEO |
| Phone | 8136439669 |
Taxonomy
| Taxonomy Code | 103K00000X - Behavior Analyst |
| License Number | L14000134355 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| License Number | L14000134355 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 016104300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PAWLISZ ANTHONY R | Agent | 2905 MOSSY TIMBER TRAIL, VALRICO, FL, 33596 |
| Name | Role | Address |
|---|---|---|
| PAWLISZ ANTHONY R | Chief Executive Officer | 2905 MOSSY TIMBER TRAIL, VALRICO, FL, 33596 |
| Name | Role | Address |
|---|---|---|
| PAWLISZ KELLY W | Authorized Member | 2905 MOSSY TIMBER TRAIL, VALRICO, FL, 33596 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| LC AMENDMENT | 2014-11-20 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2016-04-14 |
| ANNUAL REPORT | 2015-02-25 |
| LC Amendment | 2014-11-20 |
| Florida Limited Liability | 2014-08-27 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
