| Entity Name: | INNOVATIVE CHILDREN'S THERAPY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 24 Mar 2005 (20 years ago) |
| Date of dissolution: | 16 Dec 2013 (11 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 16 Dec 2013 (11 years ago) |
| Document Number: | P05000044683 |
| FEI/EIN Number | 542170281 |
| Address: | 5423 LAKE HOWELL ROAD, WINTER PARK, FL, 32792 |
| Mail Address: | 5423 LAKE HOWELL ROAD, WINTER PARK, FL, 32792 |
| ZIP code: | 32792 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1083785810 | 2006-11-13 | 2011-01-24 | 4819 FISKE CIR, ORLANDO, FL, 328264278, US | 5423 LAKE HOWELL RD, WINTER PARK, FL, 327921033, US | |||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||
| Phone | +1 407-679-7837 |
Authorized person
| Name | MRS. DAYNA JILL BRUNETTE |
| Role | PRESIDENT |
| Phone | 4076797837 |
Taxonomy
| Taxonomy Code | 2251P0200X - Pediatric Physical Therapist |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 225XP0200X - Pediatric Occupational Therapist |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 890816800 |
| State | FL |
| Name | Role |
|---|---|
| SPIEGEL & UTRERA, P.A. | Agent |
| Name | Role | Address |
|---|---|---|
| BRUNETTE DAYNA | President | 5423 LAKE HOWELL ROAD, WINTER PARK, FL, 32792 |
| Name | Role | Address |
|---|---|---|
| BRUNETTE DAYNA | Director | 5423 LAKE HOWELL ROAD, WINTER PARK, FL, 32792 |
| MACLAREN TREVOR | Director | 5423 LAKE HOWELL ROAD, WINTER PARK, FL, 32792 |
| WATSON ARIANA | Director | 5423 LAKE HOWELL ROAD, WINTER PARK, FL, 32792 |
| Name | Role | Address |
|---|---|---|
| MACLAREN TREVOR | Vice President | 5423 LAKE HOWELL ROAD, WINTER PARK, FL, 32792 |
| Name | Role | Address |
|---|---|---|
| WATSON ARIANA | Secretary | 5423 LAKE HOWELL ROAD, WINTER PARK, FL, 32792 |
| Name | Role | Address |
|---|---|---|
| WATSON ARIANA | Treasurer | 5423 LAKE HOWELL ROAD, WINTER PARK, FL, 32792 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2013-12-16 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2008-01-11 | 5423 LAKE HOWELL ROAD, WINTER PARK, FL 32792 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2006-01-15 | 5423 LAKE HOWELL ROAD, WINTER PARK, FL 32792 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2013-12-16 |
| ANNUAL REPORT | 2013-04-25 |
| ANNUAL REPORT | 2012-01-10 |
| ANNUAL REPORT | 2011-01-10 |
| ANNUAL REPORT | 2010-02-14 |
| ANNUAL REPORT | 2009-04-15 |
| ANNUAL REPORT | 2008-01-11 |
| ANNUAL REPORT | 2007-01-09 |
| ANNUAL REPORT | 2006-01-15 |
| Misc | 2005-12-14 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
