| Entity Name: | EMERALD HILLS HAND THERAPY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 03 Jun 2019 (6 years ago) |
| Document Number: | L19000147230 |
| FEI/EIN Number | 84-2081330 |
| Address: | 4420 Sheridan street suite A, HOLLYWOOD, FL, 33021, US |
| Mail Address: | 4420 Sheridan street suite A, HOLLYWOOD, FL, 33021, US |
| ZIP code: | 33021 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1144852872 | 2020-02-11 | 2024-09-20 | 4420 SHERIDAN ST STE A, HOLLYWOOD, FL, 330213552, US | 4420 SHERIDAN ST STE A, HOLLYWOOD, FL, 330213552, US | |||||||||||||||||||||
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| Phone | +1 754-201-1340 |
| Fax | 7544843918 |
Authorized person
| Name | ANDREW CRAIG |
| Role | OWNER |
| Phone | 7542011340 |
Taxonomy
| Taxonomy Code | 225XH1200X - Hand Occupational Therapist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 106340800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CRAIG ANDREW | Agent | 4420 Sheridan street suite A, HOLLYWOOD, FL, 33021 |
| Name | Role | Address |
|---|---|---|
| CRAIG ANDREW | Authorized Member | 3406 WATER OAK DRIVE, HOLLYWOOD, FL, 33021 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2020-03-07 | 4420 Sheridan street suite A, HOLLYWOOD, FL 33021 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-03-07 | 4420 Sheridan street suite A, HOLLYWOOD, FL 33021 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-03-06 | 4420 Sheridan street suite A, HOLLYWOOD, FL 33021 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-06 |
| ANNUAL REPORT | 2023-03-19 |
| ANNUAL REPORT | 2022-07-18 |
| ANNUAL REPORT | 2021-03-14 |
| ANNUAL REPORT | 2020-03-07 |
| Florida Limited Liability | 2019-06-03 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
