| Entity Name: | MODIFIED INDEPENDENCE EVALUATIONS INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 18 Sep 2019 (5 years ago) |
| Document Number: | P19000073795 |
| FEI/EIN Number | 84-3220385 |
| Address: | 1280 HARBOUR TOWN DRIVE, ORANGE PARK, FL, 32065, US |
| Mail Address: | 1280 HARBOUR TOWN DRIVE, ORANGE PARK, FL, 32065, US |
| ZIP code: | 32065 |
| County: | Clay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1356037980 | 2023-04-17 | 2023-04-17 | 1280 HARBOUR TOWN DR, ORANGE PARK, FL, 320652562, US | 1280 HARBOUR TOWN DR, ORANGE PARK, FL, 320652562, US | |||||||||||||
|
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| Phone | +1 904-710-8571 |
Authorized person
| Name | KRISTOPHER WILSON |
| Role | AUTHORIZED OFFICIAL |
| Phone | 9047108571 |
Taxonomy
| Taxonomy Code | 225X00000X - Occupational Therapist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| WILSON KRISTOPHER | Agent | 1280 HARBOUR TOWN DRIVE, ORANGE PARK, FL, 32065 |
| Name | Role | Address |
|---|---|---|
| WILSON KRISTOPHER | President | 1280 HARBOUR TOWN DRIVE, ORANGE PARK, FL, 32065 |
| Name | Role | Address |
|---|---|---|
| WILSON CARRIE | Vice President | 1280 HARBOUR TOWN DRIVE, ORANGE PARK, FL, 32065 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000156212 | MIE | ACTIVE | 2023-12-22 | 2028-12-31 | No data | 1280 HARBOUR TOWN DRIVE, ORANGE PARK, FL, 32065 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-20 |
| ANNUAL REPORT | 2023-01-14 |
| ANNUAL REPORT | 2022-02-01 |
| ANNUAL REPORT | 2021-02-01 |
| ANNUAL REPORT | 2020-06-10 |
| Domestic Profit | 2019-09-18 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
