| Entity Name: | EARTHWISE MIDWIFERY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 12 Sep 2016 (8 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | L16000169569 |
| FEI/EIN Number | 813837374 |
| Address: | 6423 RIDGE CREST DRIVE, NEW PORT RICHEY, FL, 34668, US |
| Mail Address: | 6423 RIDGE CREST DRIVE, NEW PORT RICHEY, FL, 34668, US |
| ZIP code: | 34668 |
| County: | Pasco |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336671221 | 2017-03-30 | 2017-03-30 | 6423 RIDGE CREST DR, PORT RICHEY, FL, 346685233, US | 6423 RIDGE CREST DR, PORT RICHEY, FL, 346685233, US | |||||||||||||||||||||||
|
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| Phone | +1 813-215-3287 |
Authorized person
| Name | MICHELLE BARBOUR |
| Role | OWNER |
| Phone | 8132153287 |
Taxonomy
| Taxonomy Code | 176B00000X - Midwife |
| License Number | MW286 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 014438300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BARBOUR MICHELLE | Agent | 6423 RIDGE CREST DRIVE, NEW PORT RICHEY, FL, 34668 |
| Name | Role | Address |
|---|---|---|
| BARBOUR MICHELLE | Authorized Member | 6423 RIDGE CREST DRIVE, NEW PORT RICHEY, FL, 34668 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2017-07-05 | 6423 RIDGE CREST DRIVE, NEW PORT RICHEY, FL 34668 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-01-26 |
| ANNUAL REPORT | 2017-07-05 |
| Florida Limited Liability | 2016-09-12 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
