| Entity Name: | AMERICAN HOME THERAPY PROVIDER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 15 Jan 1998 (27 years ago) |
| Date of dissolution: | 26 Sep 2014 (10 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2014 (10 years ago) |
| Document Number: | P98000005158 |
| FEI/EIN Number | 650804860 |
| Address: | 2421 SHREVE ST, SUITE 115, PUNTA GORDA, FL, 33950 |
| Mail Address: | 2421 SHREVE ST, SUITE 115, PUNTA GORDA, FL, 33950 |
| ZIP code: | 33950 |
| County: | Charlotte |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1972681724 | 2006-11-01 | 2009-03-31 | 2421 SHREVE ST STE 113, PUNTA GORDA, FL, 339505972, US | 2421 SHREVE ST STE 113, PUNTA GORDA, FL, 339505972, US | |||||||||||||||||||||||||||||||
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| Phone | +1 941-505-4663 |
| Fax | 9415754445 |
Authorized person
| Name | MRS. GRACE PENANO |
| Role | ADMINISTRATOR/COO |
| Phone | 9415054663 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| License Number | 299991531 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE 107737 |
| Number | 107737 |
| State | FL |
| Issuer | BCBS FL |
| Number | JW4 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PENANO EDGAR | Agent | 2421 SHREVE STREET, PUNTA GORDA, FL, 33950 |
| Name | Role | Address |
|---|---|---|
| PENANO EDGAR | Chief Executive Officer | 2421 SHREVE STREET, SUITE 115, PUNTA GORDA, FL, 33950 |
| Name | Role | Address |
|---|---|---|
| PENANO GRACE | President | 2421 SHREVE STREET, SUITE 115, PUNTA GORDA, FL, 33950 |
| Name | Role | Address |
|---|---|---|
| PENANO GRACE | Chief Financial Officer | 2421 SHREVE STREET, SUITE 115, PUNTA GORDA, FL, 33950 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-04-27 | 2421 SHREVE ST, SUITE 115, PUNTA GORDA, FL 33950 | No data |
| CHANGE OF MAILING ADDRESS | 2011-04-27 | 2421 SHREVE ST, SUITE 115, PUNTA GORDA, FL 33950 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-04-16 | 2421 SHREVE STREET, SUITE 115, PUNTA GORDA, FL 33950 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J13001819987 | TERMINATED | 1000000561283 | CHARLOTTE | 2013-12-04 | 2023-12-26 | $ 890.31 | STATE OF FLORIDA5000206 |
| J14000797802 | LAPSED | CACE-14-014592 | BROWARD CIRCUIT COURT | 2013-09-24 | 2019-08-01 | $27,793.90 | DE LAGE LANDEN FINANCIAL SERVICES, INC., 1111 OLD EAGLE SCHOOL ROAD, WAYNE, PA 19087 |
| J13000869322 | TERMINATED | 1000000497372 | CHARLOTTE | 2013-04-24 | 2023-05-03 | $ 2,216.29 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, FORT MYERS SERVICE CENTER, 2295 VICTORIA AVE STE 270, FORT MYERS FL339013871 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2013-04-03 |
| ANNUAL REPORT | 2012-04-09 |
| ANNUAL REPORT | 2011-04-27 |
| ANNUAL REPORT | 2010-04-29 |
| ANNUAL REPORT | 2009-04-16 |
| ANNUAL REPORT | 2008-04-24 |
| ANNUAL REPORT | 2007-04-16 |
| ANNUAL REPORT | 2006-04-17 |
| ANNUAL REPORT | 2005-04-25 |
| ANNUAL REPORT | 2004-04-02 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
