| Entity Name: | CREATIVE KIDS THERAPY INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 27 Sep 2019 (5 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 25 Apr 2024 (9 months ago) |
| Document Number: | P19000076236 |
| FEI/EIN Number | 84-3332248 |
| Address: | 5901 NW 151 STREET, MIAMI LAKES, FL, 33014, US |
| Mail Address: | 5901 NW 151 STREET, MIAMI LAKES, FL, 33014, US |
| ZIP code: | 33014 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1942842968 | 2019-10-10 | 2023-03-07 | 5901 NW 151ST ST STE 124, MIAMI LAKES, FL, 330142454, US | 5881 NW 151ST ST STE 126, MIAMI LAKES, FL, 330142442, US | |||||||||||||||||||||||||
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| Phone | +1 786-432-5099 |
| Fax | 7864325100 |
Authorized person
| Name | MS. CRISTINA MARIA MARQUEZ |
| Role | PRESIDENT |
| Phone | 7864325099 |
Taxonomy
| Taxonomy Code | 252Y00000X - Early Intervention Provider Agency |
| Is Primary | No |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 104541800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MARQUEZ CRISTINA M | Agent | 5901 NW 151 STREET, MIAMI LAKES, FL, 33014 |
| Name | Role | Address |
|---|---|---|
| MARQUEZ CRISTINA M | President | 5901 NW 151 STREET, MIAMI LAKES, FL, 33014 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2024-04-25 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2024-04-25 | MARQUEZ, CRISTINA M | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-09-14 | 5901 NW 151 STREET, SUITE 124, MIAMI LAKES, FL 33014 | No data |
| CHANGE OF MAILING ADDRESS | 2022-09-14 | 5901 NW 151 STREET, SUITE 124, MIAMI LAKES, FL 33014 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-09-14 | 5901 NW 151 STREET, SUITE 124, MIAMI LAKES, FL 33014 | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2024-04-25 |
| ANNUAL REPORT | 2022-09-14 |
| ANNUAL REPORT | 2021-04-07 |
| ANNUAL REPORT | 2020-01-14 |
| Domestic Profit | 2019-09-27 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
