| Entity Name: | KOMO THERAPY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 16 Sep 2021 (3 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 22 Sep 2021 (3 years ago) |
| Document Number: | L21000410963 |
| FEI/EIN Number | 87-2816608 |
| Address: | 10570 127th Avenue North, Largo, FL, 33773, US |
| Mail Address: | 10570 127th Avenue North, Largo, FL, 33773, US |
| ZIP code: | 33773 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1710621875 | 2022-04-25 | 2022-04-25 | 10570 127TH AVE, LARGO, FL, 337731026, US | 10570 127TH AVE, LARGO, FL, 337731026, US | |||||||||||||||||||||
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| Phone | +1 727-244-5865 |
| Fax | 7278128185 |
Authorized person
| Name | MRS. KAREN DIDOVETS |
| Role | OWNER |
| Phone | 7272445865 |
Taxonomy
| Taxonomy Code | 225XP0200X - Pediatric Occupational Therapist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 7272445865 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DIDOVETS KAREN B | Agent | 10570 127TH AVENUE NORTH, LARGO, FL, 33773 |
| Name | Role | Address |
|---|---|---|
| DIDOVETS KAREN B | Manager | 10570 127TH AVENUE NORTH, LARGO, FL, 33773 |
| Name | Role | Address |
|---|---|---|
| Congelosi Micheal P | Authorized Member | 10570 127th Avenue North, Largo, FL, 33773 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-04-25 | 10570 127th Avenue North, Largo, FL 33773 | No data |
| CHANGE OF MAILING ADDRESS | 2022-04-25 | 10570 127th Avenue North, Largo, FL 33773 | No data |
| LC AMENDMENT | 2021-09-22 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-09 |
| ANNUAL REPORT | 2023-04-28 |
| ANNUAL REPORT | 2022-04-25 |
| LC Amendment | 2021-09-22 |
| Florida Limited Liability | 2021-09-16 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
