| Entity Name: | EPOCH PHYSICAL THERAPY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 03 Mar 2021 (4 years ago) |
| Date of dissolution: | 23 Sep 2022 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (2 years ago) |
| Document Number: | L21000104317 |
| Address: | 300 N New York Ave #383, WINTER PARK, FL, 32789, US |
| Mail Address: | PO BOX 383, Wintre Park, FL, 32790, US |
| ZIP code: | 32789 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508445669 | 2021-04-06 | 2021-05-10 | PO BOX 383, WINTER PARK, FL, 327900383, US | 2333 WESTMINSTER CT, WINTER PARK, FL, 327893451, US | |||||||||||||||||||
|
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| Phone | +1 407-879-2028 |
Authorized person
| Name | DR. MICHELLE LYNN NELSON |
| Role | OWNER |
| Phone | 4078792028 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1619413713 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| NELSON MICHELLE L | Agent | 2333 WESTMINSTER COURT, WINTER PARK, FL, 32789 |
| Name | Role | Address |
|---|---|---|
| NELSON MICHELLE L | Manager | 2333 WESTMINSTER COURT, WINTER PARK, FL, 32789 |
| CORLESS KASEY L | Manager | 2333 WESTMINSTER COURT, WINTER PARK, FL, 32789 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-20 | 300 N New York Ave #383, WINTER PARK, FL 32789 | No data |
| CHANGE OF MAILING ADDRESS | 2021-04-20 | 300 N New York Ave #383, WINTER PARK, FL 32789 | No data |
| Name | Date |
|---|---|
| Florida Limited Liability | 2021-03-03 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
