| Entity Name: | KRISTEN A. E. BOHAN, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 07 Mar 2008 (17 years ago) |
| Document Number: | P08000024863 |
| FEI/EIN Number | 262288574 |
| Address: | 7333 International Place, SARASOTA, FL, 34240, US |
| Mail Address: | 7333 International Place, SARASOTA, FL, 34240, US |
| ZIP code: | 34240 |
| County: | Sarasota |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1679748867 | 2008-04-28 | 2022-10-11 | 7333 INTERNATIONAL PLACE, SARASOTA, FL, 34240, US | 7333 INTERNATIONAL PLACE, SARASOTA, FL, 34240, US | |||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 941-500-2333 |
| Fax | 8884119766 |
Authorized person
| Name | MRS. KRISTEN ANNE BOHAN |
| Role | OWNER |
| Phone | 9415002333 |
Taxonomy
| Taxonomy Code | 225X00000X - Occupational Therapist |
| License Number | OT4183 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 225XP0200X - Pediatric Occupational Therapist |
| License Number | OT4183 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 019315900 |
| State | FL |
| Issuer | MEDICAID |
| Number | 892176800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BOHAN KRISTEN A | Agent | 6457 Blue Grosbeak Cir, LAKEWOOD RANCH, FL, 34202 |
| Name | Role | Address |
|---|---|---|
| BOHAN KRISTEN A | President | 6457 Blue Grosbeak Cir, LAKEWOOD RANCH, FL, 34202 |
| Name | Role | Address |
|---|---|---|
| BOHAN KAITLIN | Secretary | 6457 BLUE GROSBEAK CIR, BRADENTON, FL, 34202 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000040270 | BUILDING BEYOND BASICS PEDIATRIC THERAPY | ACTIVE | 2019-03-28 | 2029-12-31 | No data | 6457 BLUE GROSBEAK CIR, LAKEWOOD RANCH, FL, 34202 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-01-17 | 7333 International Place, SARASOTA, FL 34240 | No data |
| CHANGE OF MAILING ADDRESS | 2021-01-17 | 7333 International Place, SARASOTA, FL 34240 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-03-15 | 6457 Blue Grosbeak Cir, LAKEWOOD RANCH, FL 34202 | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-05-17 |
| ANNUAL REPORT | 2024-02-09 |
| ANNUAL REPORT | 2023-01-20 |
| ANNUAL REPORT | 2022-07-17 |
| ANNUAL REPORT | 2021-01-17 |
| ANNUAL REPORT | 2020-01-20 |
| ANNUAL REPORT | 2019-04-19 |
| ANNUAL REPORT | 2018-04-29 |
| ANNUAL REPORT | 2017-04-30 |
| ANNUAL REPORT | 2016-04-24 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
