| Entity Name: | MICHELLE WILDMAN - OCCUPATIONAL THERAPIST, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Inactive |
| Date Filed: | 09 Jan 2008 (17 years ago) |
| Date of dissolution: | 28 Jan 2010 (15 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 28 Jan 2010 (15 years ago) |
| Document Number: | N08000000270 |
| FEI/EIN Number | 134331291 |
| Address: | 122 EGLIN PARKWAY N.E., FT. WALTON BEACH, FL, 32548 |
| Mail Address: | 122 EGLIN PARKWAY N.E., FT. WALTON BEACH, FL, 32548 |
| ZIP code: | 32548 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548598204 | 2009-11-18 | 2009-11-18 | 122 EGLIN PKWY NE, FORT WALTON BEACH, FL, 325484917, US | 122 EGLIN PKWY NE, FORT WALTON BEACH, FL, 325484917, US | |||||||||||||||||||
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| Phone | +1 850-543-6227 |
| Fax | 8508639973 |
Authorized person
| Name | MICHELLE ANNE WILDMAN |
| Role | DIRECTOR |
| Phone | 8505436227 |
Taxonomy
| Taxonomy Code | 251C00000X - Developmentally Disabled Services Day Training Agency |
| License Number | 11903 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| WILDMAN JOLENE | Agent | 122 EGLIN PKWY, FT. WALTON BEACH, FL, 32548 |
| Name | Role | Address |
|---|---|---|
| WILDMAN MICHELLE | President | 11 NEPTUNE DRIVE, MARY ESTHER, FL, 32569 |
| Name | Role | Address |
|---|---|---|
| WILDMAN MICHELLE | Director | 11 NEPTUNE DRIVE, MARY ESTHER, FL, 32569 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2010-01-28 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2009-01-12 | WILDMAN, JOLENE | No data |
| Name | Date |
|---|---|
| Voluntary Dissolution | 2010-01-28 |
| ANNUAL REPORT | 2009-01-12 |
| Domestic Non-Profit | 2008-01-09 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
