| Entity Name: | JUMPSTART DEVELOPMENTAL SERVICES,LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 05 Jan 2021 (4 years ago) |
| Document Number: | L21000016179 |
| FEI/EIN Number | 86-1212398 |
| Address: | 5767-B NW 151 STREET, MIAMI LAKES, FL 33014 |
| Mail Address: | 5767-B NW 151 STREET, MIAMI LAKES, FL 33014 |
| ZIP code: | 33014 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1699363291 | 2021-01-08 | 2024-10-11 | 5979 NW 151ST ST STE 102I, MIAMI LAKES, FL, 330142434, US | 5979 NW 151ST ST STE 102I, MIAMI LAKES, FL, 330142434, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 786-431-5801 |
| Fax | 7863539177 |
Authorized person
| Name | RYAN JUSTIN MONTOTO |
| Role | OWNER/OPERATOR |
| Phone | 7862451405 |
Taxonomy
| Taxonomy Code | 103K00000X - Behavior Analyst |
| Is Primary | Yes |
| Taxonomy Code | 106S00000X - Behavior Technician |
| Is Primary | No |
| Taxonomy Code | 225X00000X - Occupational Therapist |
| Is Primary | No |
| Taxonomy Code | 261QD1600X - Developmental Disabilities Clinic/Center |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 103180400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CHRISTINA, MONTOTO | Agent | 5765 NW 151 Street, Miami Lakes, FL 33014 |
| Name | Role | Address |
|---|---|---|
| MONTOTO, CHRISTINA | Chief Executive Officer | 5767-B NW 151 STREET, MIAMI LAKES, FL 33014 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-01-05 | 5767-B NW 151 STREET, MIAMI LAKES, FL 33014 | No data |
| CHANGE OF MAILING ADDRESS | 2024-01-05 | 5767-B NW 151 STREET, MIAMI LAKES, FL 33014 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-01-05 | CHRISTINA, MONTOTO | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-14 | 5765 NW 151 Street, Miami Lakes, FL 33014 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-05 |
| ANNUAL REPORT | 2023-04-14 |
| ANNUAL REPORT | 2022-03-04 |
| Florida Limited Liability | 2021-01-05 |
Date of last update: 15 Jan 2025
Sources: Florida Department of State
