| Entity Name: | FLORIDA KIDS THERAPY ASSOCIATES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 22 Jun 2017 (8 years ago) |
| Date of dissolution: | 27 Sep 2024 (4 months ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2024 (4 months ago) |
| Document Number: | L17000134009 |
| FEI/EIN Number | APPLIED FOR |
| Address: | 11055 SW 186 St., Ste 307, Cutler Bay, FL 33157 |
| Mail Address: | 11055 SW 186 St., Ste 307, Cutler Bay, FL 33157 |
| ZIP code: | 33157 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1871023150 | 2017-06-19 | 2022-07-21 | 17037 S DIXIE HWY, PALMETTO BAY, FL, 331574362, US | 17037 S DIXIE HWY, PALMETTO BAY, FL, 331574362, US | |||||||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 786-732-0384 |
| Fax | 3057671461 |
Authorized person
| Name | RAFAEL SIERRA |
| Role | MANAGER |
| Phone | 7867320384 |
Taxonomy
| Taxonomy Code | 224Z00000X - Occupational Therapy Assistant |
| License Number | OTA12521 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 2251P0200X - Pediatric Physical Therapist |
| License Number | PT26302 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 225XP0200X - Pediatric Occupational Therapist |
| License Number | OT8077 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1366887341 |
| State | FL |
| Issuer | MEDICAID |
| Number | 1831320126 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Sierra, Rafael | Agent | 11055 SW 186 St., Ste 307, Cutler Bay, FL 33157 |
| Name | Role | Address |
|---|---|---|
| Diaz, Judith | . | 11055 SW 186 St., Ste 307 Cutler Bay, FL 33157 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2022-06-02 | Sierra, Rafael | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-30 | 11055 SW 186 St., Ste 307, Cutler Bay, FL 33157 | No data |
| CHANGE OF MAILING ADDRESS | 2021-04-30 | 11055 SW 186 St., Ste 307, Cutler Bay, FL 33157 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-04-30 | 11055 SW 186 St., Ste 307, Cutler Bay, FL 33157 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J20000127908 | TERMINATED | 1000000861519 | DADE | 2020-02-24 | 2030-02-26 | $ 567.73 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, MIAMI SERVICE CENTER, 8175 NW 12TH ST STE 119, DORAL FL331261828 |
| J20000093464 | TERMINATED | 1000000858546 | MIAMI-DADE | 2020-02-04 | 2030-02-12 | $ 567.37 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, MIAMI SERVICE CENTER, 8175 NW 12TH ST STE 119, DORAL FL331261828 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2023-03-26 |
| ANNUAL REPORT | 2022-06-02 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-03-26 |
| ANNUAL REPORT | 2019-03-05 |
| ANNUAL REPORT | 2018-01-26 |
| Florida Limited Liability | 2017-06-22 |
Date of last update: 18 Jan 2025
Sources: Florida Department of State
