| Entity Name: | THE BIRTH TRIBE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 14 Jun 2019 (6 years ago) |
| Document Number: | L19000158114 |
| FEI/EIN Number | 84-2304441 |
| Address: | 7 Florida Park Drive North, Palm Coast, FL, 32137, US |
| Mail Address: | 17 Pine Grove Dr, Palm Coast, FL, 32164, US |
| ZIP code: | 32137 |
| County: | Flagler |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1558944546 | 2021-04-28 | 2021-04-28 | 17 PINE GROVE DR SIDE A, PALM COAST, FL, 321647098, US | 800 S NOVA RD STE R, ORMOND BEACH, FL, 321747362, US | |||||||||||||||||||||||
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| Phone | +1 914-299-7171 |
| Fax | 3862047117 |
| Phone | +1 386-227-7663 |
Authorized person
| Name | SERENA BURR |
| Role | MIDWIFE/OWNER |
| Phone | 9142997171 |
Taxonomy
| Taxonomy Code | 176B00000X - Midwife |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 101854800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BURR SERENA R | Agent | 800 S Nova Rd, Ormond Beach, FL, 32174 |
| Name | Role | Address |
|---|---|---|
| BURR SERENA R | Manager | 800 S NOVA RD STE R, ORMOND BEACH, FL, 32174 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-29 | 7 Florida Park Drive North, B, Palm Coast, FL 32137 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-29 | 7 Florida Park Drive North, B, Palm Coast, FL 32137 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-04-25 | 800 S Nova Rd, Suite r, Ormond Beach, FL 32174 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-04-11 |
| ANNUAL REPORT | 2022-04-24 |
| ANNUAL REPORT | 2021-04-25 |
| ANNUAL REPORT | 2020-06-30 |
| Florida Limited Liability | 2019-06-14 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
