| Entity Name: | INTERACTIVE HEALTH ALLIANCE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 31 Jul 2017 (8 years ago) |
| Document Number: | L17000163164 |
| FEI/EIN Number | NOT APPLICABLE |
| Address: | 1463 OAKFIELD DRIVE, SUITE 133, TAMPA, FL, 33511, US |
| Mail Address: | 1463 OAKFIELD DRIVE, SUITE 133, TAMPA, FL, 33511, US |
| ZIP code: | 33511 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1023525375 | 2018-01-09 | 2019-06-11 | 1463 OAKFIELD DR STE 133, BRANDON, FL, 335110802, US | 1463 OAKFIELD DR STE 133, BRANDON, FL, 335110802, US | |||||||||||||||||||
|
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| Phone | +1 813-315-8860 |
Authorized person
| Name | MS. OLIVENE EDWARDS |
| Role | OWNER |
| Phone | 8133158860 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 022514800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Samuda Kirk | Agent | 5835 TULIP FLOWER DR, RIVERVIEW, FL, 33578 |
| Name | Role | Address |
|---|---|---|
| EDWARDS OLIVENE | Authorized Member | 5825 TULIP FLOWER DRIVE, RIVERVIEW, FL, 33578 |
| SAMUDA KIRK | Authorized Member | 5825 TULIP FLOWER DRIVE, RIVERVIEW, FL, 33578 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2019-06-27 | 1463 OAKFIELD DRIVE, SUITE 133, TAMPA, FL 33511 | No data |
| CHANGE OF MAILING ADDRESS | 2019-06-27 | 1463 OAKFIELD DRIVE, SUITE 133, TAMPA, FL 33511 | No data |
| REGISTERED AGENT NAME CHANGED | 2018-09-06 | Samuda, Kirk | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-17 |
| ANNUAL REPORT | 2023-01-15 |
| ANNUAL REPORT | 2022-03-08 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-06-30 |
| ANNUAL REPORT | 2019-06-27 |
| ANNUAL REPORT | 2018-09-06 |
| Florida Limited Liability | 2017-07-31 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
