| Entity Name: | OMNIA ORTHOPEDIC AND PAIN SPECIALISTS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 19 Feb 2019 (6 years ago) |
| Date of dissolution: | 25 Sep 2020 (4 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2020 (4 years ago) |
| Document Number: | L19000049390 |
| Address: | 1803 PARK CENTER DRIVE, SUIT #103, ORLANDO, FL 32835 |
| Mail Address: | 1803 PARK CENTER DRIVE, SUIT #103, ORLANDO, FL 32835 |
| ZIP code: | 32835 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1689136558 | 2019-04-01 | 2019-04-05 | 1803 PARK CENTER DR, ORLANDO, FL, 328356216, US | 1803 PARK CENTER DR, ORLANDO, FL, 328356216, US | |||||||||||||||||||
|
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| Phone | +1 518-365-5817 |
Authorized person
| Name | DR. MATTHEW EDWARD MCCABE |
| Role | OWNER/CHIROPRACTIC PHYSICIAN |
| Phone | 5183655817 |
Taxonomy
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1730407917 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MCCABE, MATTHEW | Agent | 1803 PARK CENTER DRIVE, STE #103, ORLANDO, FL 32835 |
| Name | Role | Address |
|---|---|---|
| MCCABE, MATTHEW | Manager | 1803 PARK CENTER DRIVE, STE #103 ORLANDO, FL 32835 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| LC AMENDMENT | 2019-03-29 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-03-28 | 1803 PARK CENTER DRIVE, STE #103, ORLANDO, FL 32835 | No data |
| Name | Date |
|---|---|
| LC Amendment | 2019-03-29 |
| Florida Limited Liability | 2019-02-19 |
Date of last update: 17 Jan 2025
Sources: Florida Department of State
