| Entity Name: | ASSISTIVE TECHNOLOGY EVALUATIONS & SERVICES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 29 Jul 2016 (9 years ago) |
| Document Number: | L16000142867 |
| FEI/EIN Number | 81-3400281 |
| Address: | 1357 SELBYDON WAY, WINTER GARDEN, FL 34787 |
| Mail Address: | 1357 SELBYDON WAY, WINTER GARDEN, FL 34787 |
| ZIP code: | 34787 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1346780483 | 2017-03-07 | 2021-06-19 | 1357 SELBYDON WAY, WINTER GARDEN, FL, 347874652, US | 1357 SELBYDON WAY, WINTER GARDEN, FL, 347874652, US | |||||||||||||||||||||||||
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| Phone | +1 352-536-4981 |
Authorized person
| Name | JEFFREY SAMUEL DAVIS |
| Role | OWNER |
| Phone | 3525364981 |
Taxonomy
| Taxonomy Code | 225CA2400X - Assistive Technology Practitioner Rehabilitation Counselor |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 018949100 |
| State | FL |
| Issuer | MEDICAID |
| Number | 018669400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Van Vorhees, Tyler S, Esq. | Agent | 5736 SW. 49th St., Miami, FL 33155 |
| Name | Role | Address |
|---|---|---|
| DAVIS, JEFFREY S, Phd | President | 1357 SELBYDON WAY, WINTER GARDEN, FL 34787 |
| Name | Role | Address |
|---|---|---|
| Davis, Linda Kanowitz | Other | 11324 Sweetwater Ct, Clermont, FL 34715 |
| Davis, Jamie Lyn-Andersen | Other | 1357 Selbydon Way, Winter Garden, FL 34787 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2023-01-30 | 5736 SW. 49th St., Miami, FL 33155 | No data |
| REGISTERED AGENT NAME CHANGED | 2020-03-23 | Van Vorhees, Tyler S, Esq. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-24 |
| ANNUAL REPORT | 2023-01-30 |
| ANNUAL REPORT | 2022-01-28 |
| ANNUAL REPORT | 2021-02-04 |
| ANNUAL REPORT | 2020-03-23 |
| ANNUAL REPORT | 2019-04-04 |
| ANNUAL REPORT | 2018-02-17 |
| ANNUAL REPORT | 2017-01-29 |
| Florida Limited Liability | 2016-07-29 |
Date of last update: 19 Jan 2025
Sources: Florida Department of State
