| Entity Name: | DBT ORLANDO, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 09 Oct 2019 (5 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 04 Nov 2024 (3 months ago) |
| Document Number: | L19000254344 |
| FEI/EIN Number | 84-3452355 |
| Address: | 711 N Orlando Ave, Maitland, FL, 32751, US |
| Mail Address: | 711 N Orlando Ave, Maitland, FL, 32751, US |
| ZIP code: | 32751 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1407447980 | 2021-01-28 | 2021-01-28 | 711 N ORLANDO AVE STE 203A, MAITLAND, FL, 327514403, US | 978 DOUGLAS AVE STE 107, ALTAMONTE SPRINGS, FL, 327145205, US | |||||||||||||||||||||
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| Phone | +1 407-754-6967 |
| Phone | +1 321-417-7299 |
Authorized person
| Name | MARIBEL J RODRIGUEZ |
| Role | COUNSELOR / OWNER |
| Phone | 4077546967 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | UNK |
| State | FL |
| Name | Role | Address |
|---|---|---|
| OLIN ERIC | Agent | 711 N ORLANDO AVE, MAITLAND, FL, 32751 |
| Name | Role | Address |
|---|---|---|
| Olin Eric | Part | 711 N Orlando Ave, Maitland, FL, 32751 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2024-11-04 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2024-11-04 | OLIN, ERIC | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-11-04 | 711 N ORLANDO AVE, STE 203, MAITLAND, FL 32751 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-11-17 | 711 N Orlando Ave, 203, Maitland, FL 32751 | No data |
| REINSTATEMENT | 2021-11-17 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2021-11-17 | 711 N Orlando Ave, 203, Maitland, FL 32751 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| LC DISSOCIATION MEM | 2020-06-16 | No data | No data |
| Name | Date |
|---|---|
| LC Amendment | 2024-11-04 |
| ANNUAL REPORT | 2024-04-24 |
| ANNUAL REPORT | 2023-01-30 |
| ANNUAL REPORT | 2022-02-08 |
| REINSTATEMENT | 2021-11-17 |
| CORLCDSMEM | 2020-06-16 |
| ANNUAL REPORT | 2020-05-04 |
| Florida Limited Liability | 2019-10-09 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
