| Entity Name: | VALENCIA PSYCHIATRY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
VALENCIA PSYCHIATRY LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 16 Oct 2020 (4 years ago) |
| Document Number: | L20000328431 |
| FEI/EIN Number |
85-3625524
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 4151 HUNTERS PARK LANE SUITE 100, ORLANDO, FL, 32837, US |
| Mail Address: | 4151 HUNTERS PARK LANE SUITE 100, ORLANDO, FL, 32837, US |
| ZIP code: | 32837 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1447795612 | 2016-12-27 | 2016-12-27 | 4151 HUNTERS PARK LN, 100, ORLANDO, FL, 328373617, US | 4151 HUNTERS PARK LN, 100, ORLANDO, FL, 328373617, US | |||||||||||||||||||||||||
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| Phone | +1 407-856-8830 |
| Fax | 4078568802 |
Authorized person
| Name | EDIE LONDON |
| Role | OFFICE MANAGER |
| Phone | 4078568830 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| License Number | ME62465 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 371312100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ESTEPA PURUCA MANUELA | Authorized Member | 4151 HUNTERS PARK LANE SUITE 100, ORLANDO, FL, 32837 |
| TAITT EARL PAUL JR | Authorized Member | 4151 HUNTERS PARK LANE SUITE 100, ORLANDO, FL, 32837 |
| KMG CPA, LLC | Agent | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-05-01 |
| ANNUAL REPORT | 2022-04-29 |
| ANNUAL REPORT | 2021-04-29 |
| Florida Limited Liability | 2020-10-16 |
Date of last update: 01 Mar 2025
Sources: Florida Department of State
