| Entity Name: | ETIKIDS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 19 Sep 2014 (10 years ago) |
| Date of dissolution: | 10 Dec 2018 (6 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 10 Dec 2018 (6 years ago) |
| Document Number: | L14000147084 |
| FEI/EIN Number | 47-1889255 |
| Address: | 13602 S VILLAGE DR,, UNIT 313, TAMPA, FL, 33618, US |
| Mail Address: | 13602 S VILLAGE DR,, UNIT 313, TAMPA, FL, 33618, US |
| ZIP code: | 33618 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1306248059 | 2014-09-24 | 2016-11-16 | 1722 MAGDALENE MANOR DR, TAMPA, FL, 336131917, US | 1722 MAGDALENE MANOR DR, TAMPA, FL, 336131917, US | |||||||||||||||||||||||||
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| Phone | +1 813-856-9449 |
| Fax | 8139626831 |
Authorized person
| Name | JULIE BLACKER |
| Role | OCCUPATIONAL THERAPIST |
| Phone | 6465444485 |
Taxonomy
| Taxonomy Code | 225X00000X - Occupational Therapist |
| License Number | 16418 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 013898400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BLACKER JULIE | Agent | 1722 MAGDALENE MANOR DR, TAMPA, FL, 336131917 |
| Name | Role | Address |
|---|---|---|
| BLACKER JULIE | Manager | 1722 MAGDALENE MANOR DR, TAMPA, FL, 336131917 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2018-12-10 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-07-23 | 13602 S VILLAGE DR,, UNIT 313, TAMPA, FL 33618 | No data |
| CHANGE OF MAILING ADDRESS | 2018-07-23 | 13602 S VILLAGE DR,, UNIT 313, TAMPA, FL 33618 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-01-03 | 1722 MAGDALENE MANOR DR, TAMPA, FL 33613-1917 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2018-12-10 |
| ANNUAL REPORT | 2018-01-21 |
| ANNUAL REPORT | 2017-01-03 |
| ANNUAL REPORT | 2016-01-15 |
| ANNUAL REPORT | 2015-01-08 |
| Florida Limited Liability | 2014-09-19 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
