| Entity Name: | KIDS AT WORK OCCUPATIONAL THERAPY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 11 Aug 2010 (14 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 27 Jan 2012 (13 years ago) |
| Document Number: | P10000066002 |
| FEI/EIN Number | 273209662 |
| Address: | 8441 BOWIE WAY, LAKE WORTH, FL, 33467, US |
| Mail Address: | 8441 BOWIE WAY, LAKE WORTH, FL, 33467, US |
| ZIP code: | 33467 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1437639010 | 2018-08-14 | 2018-08-14 | 8441 BOWIE WAY, LAKE WORTH, FL, 334671176, US | 8441 BOWIE WAY, LAKE WORTH, FL, 334671176, US | |||||||||||||||||||||||||
|
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| Phone | +1 561-315-9726 |
| Fax | 5619673837 |
Authorized person
| Name | SHAUNA M KRZANOWSKI |
| Role | OCCUPATIONAL THERAPIST |
| Phone | 5613159726 |
Taxonomy
| Taxonomy Code | 225XP0200X - Pediatric Occupational Therapist |
| License Number | OT2306 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 880307200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| KRZANOWSKI SHAUNA M | Agent | 8441 BOWIE WAY, LAKE WORTH, FL, 33467 |
| Name | Role | Address |
|---|---|---|
| KRZANOWSKI SHAUNA M | President | 8441 BOWIE WAY, LAKE WORTH, FL, 33467 |
| Name | Role | Address |
|---|---|---|
| KRZANOWSKI MATTHEW J | Vice President | 8441 BOWIE WAY, LAKE WORTH, FL, 33467 |
| Name | Role | Address |
|---|---|---|
| KRZANOWSKI SHAUNA M | Secretary | 8441 BOWIE WAY, LAKE WORTH, FL, 33467 |
| Name | Role | Address |
|---|---|---|
| KRZANOWSKI SHAUNA M | Treasurer | 8441 BOWIE WAY, LAKE WORTH, FL, 33467 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2012-01-27 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-24 |
| ANNUAL REPORT | 2023-04-10 |
| ANNUAL REPORT | 2022-03-27 |
| ANNUAL REPORT | 2021-04-20 |
| ANNUAL REPORT | 2020-04-28 |
| ANNUAL REPORT | 2019-03-30 |
| ANNUAL REPORT | 2018-04-04 |
| ANNUAL REPORT | 2017-03-20 |
| ANNUAL REPORT | 2016-04-24 |
| ANNUAL REPORT | 2015-03-01 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
