| Entity Name: | FOSSITT THERAPY SERVICES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 29 Dec 2003 (21 years ago) |
| Document Number: | P03000158269 |
| FEI/EIN Number | 200638079 |
| Address: | 2015 S. MAPLE AVE, SANFORD, FL, 32771 |
| Mail Address: | 289 BRASSINGTON DRIVE, DEBARY, FL, 32713 |
| ZIP code: | 32771 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811940471 | 2006-05-17 | 2012-01-17 | 289 BRASSINGTON DR, DEBARY, FL, 327132138, US | 2015 S MAPLE AVE, SANFORD, FL, 327713361, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 407-792-8590 |
| Fax | 4073285430 |
| Phone | +1 407-328-5420 |
Authorized person
| Name | MR. LAWRENCE ALLEN FOSSITT |
| Role | PRESIDENT |
| Phone | 4073285420 |
Taxonomy
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| License Number | PT 19048 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| License Number | OT 10292 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| License Number | SA 1721 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| FOSSITT LAWRENCE A | Agent | 289 BRASSINGTON DRIVE, DEBARY, FL, 32713 |
| Name | Role | Address |
|---|---|---|
| FOSSITT LAWRENCE A | President | 289 BRASSINGTON DRIVE, DEBARY, FL, 32713 |
| Name | Role | Address |
|---|---|---|
| LACAILLE VASHTI | Secretary | 289 BRASSINGTON DRIVE, DEBARY, FL, 32713 |
| Name | Role | Address |
|---|---|---|
| LACAILLE VASHTI | Treasurer | 289 BRASSINGTON DRIVE, DEBARY, FL, 32713 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2011-09-02 | 2015 S. MAPLE AVE, SANFORD, FL 32771 | No data |
| CHANGE OF MAILING ADDRESS | 2005-02-21 | 2015 S. MAPLE AVE, SANFORD, FL 32771 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2005-02-21 | 289 BRASSINGTON DRIVE, DEBARY, FL 32713 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-26 |
| ANNUAL REPORT | 2024-02-05 |
| ANNUAL REPORT | 2023-01-03 |
| ANNUAL REPORT | 2022-01-06 |
| ANNUAL REPORT | 2021-01-04 |
| ANNUAL REPORT | 2020-01-14 |
| ANNUAL REPORT | 2019-01-30 |
| ANNUAL REPORT | 2018-01-03 |
| ANNUAL REPORT | 2017-01-07 |
| ANNUAL REPORT | 2016-01-04 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
