| Entity Name: | DR. AIXA LONG, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 07 Mar 2022 (3 years ago) |
| Document Number: | L22000115222 |
| FEI/EIN Number | 88-1630957 |
| Address: | 601 WEBSTER ST, WILDWOOD, FL 34785 |
| Mail Address: | 9807 PEPPER TREE PL, WILDWOOD, FL 34785 |
| ZIP code: | 34785 |
| County: | Sumter |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1467171363 | 2022-08-24 | 2022-08-24 | 9807 PEPPER TREE PLACE, WILDWOOD, FL, 34785, US | 601 WEBSTER ST, WILDWOOD, FL, 347853828, US | |||||||||||||||
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| Phone | +1 813-784-7340 |
| Phone | +1 352-432-8892 |
Authorized person
| Name | DR. AIXA LONG |
| Role | OWNER |
| Phone | 8137847340 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LONG, AIXA L | Agent | 9807 PEPPER TREE PL, WILDWOOD, FL 34785 |
| Name | Role | Address |
|---|---|---|
| Long, Matthew | Authorized Member | 9807 PEPPER TREE PL, WILDWOOD, FL 34785 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2023-02-24 | 9807 PEPPER TREE PL, WILDWOOD, FL 34785 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-04 |
| ANNUAL REPORT | 2023-02-24 |
| Florida Limited Liability | 2022-03-07 |
Date of last update: 12 Jan 2025
Sources: Florida Department of State
