| Entity Name: | SHELLEY CARMINE BOWLES, LCSW, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 29 Jan 2004 (21 years ago) |
| Document Number: | P04000020221 |
| FEI/EIN Number | 200674628 |
| Address: | 9100 Conroy Windermere Road, Suite 200, Windermere, FL, 34786, US |
| Mail Address: | 9100 Conroy Windermere Road, Suite 200, Windermere, FL, 34786, US |
| ZIP code: | 34786 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1750839536 | 2016-09-21 | 2016-09-21 | 5728 MAJOR BLVD, #175, ORLANDO, FL, 328197961, US | 5728 MAJOR BLVD, #175, ORLANDO, FL, 328197961, US | |||||||||||||||||
|
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| Phone | +1 407-325-5719 |
Authorized person
| Name | SHELLEY BOWLES |
| Role | PSYCHOTHERAPIST |
| Phone | 4073255719 |
Taxonomy
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| License Number | SW5066 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BOWLES SHELLEY L | Agent | 9100 Conroy Windermere Road, Windermere, FL, 34786 |
| Name | Role | Address |
|---|---|---|
| BOWLES Shelley L | President | 9100 Conroy Windermere Road, Windermere, FL, 34786 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-02-22 | 9100 Conroy Windermere Road, Suite 200, Windermere, FL 34786 | No data |
| CHANGE OF MAILING ADDRESS | 2021-02-22 | 9100 Conroy Windermere Road, Suite 200, Windermere, FL 34786 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-02-22 | 9100 Conroy Windermere Road, Suite 200, Windermere, FL 34786 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-04 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-03-02 |
| ANNUAL REPORT | 2021-02-22 |
| ANNUAL REPORT | 2020-04-02 |
| ANNUAL REPORT | 2019-04-13 |
| ANNUAL REPORT | 2018-03-26 |
| ANNUAL REPORT | 2017-02-17 |
| ANNUAL REPORT | 2016-04-27 |
| ANNUAL REPORT | 2015-03-15 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
