| Entity Name: | BAYSIDE FAMILY HEALTHCARE CLEARWATER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
BAYSIDE FAMILY HEALTHCARE CLEARWATER, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 01 Aug 2007 (18 years ago) |
| Date of dissolution: | 23 Sep 2011 (14 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2011 (14 years ago) |
| Document Number: | L07000079084 |
| FEI/EIN Number |
352312012
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 107 MCMULLEN BOOTH ROAD NORTH, CLEARWATER, FL, 33759 |
| Mail Address: | 107 MCMULLEN BOOTH ROAD NORTH, CLEARWATER, FL, 33759 |
| ZIP code: | 33759 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1760791859 | 2010-10-06 | 2010-10-06 | 107 N MCMULLEN BOOTH RD, CLEARWATER, FL, 337594450, US | 107 N MCMULLEN BOOTH RD, CLEARWATER, FL, 337594450, US | |||||||||||||||||||||||||
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| Phone | +1 727-504-7073 |
| Fax | 8132003313 |
Authorized person
| Name | PATRICK E HICKEY |
| Role | MGRM |
| Phone | 7275047073 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ME85120 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 274541100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HICKEY PATRICK E | Managing Member | 1775 SPLIT FORK DRIVE, OLDSMAR, FL, 34677 |
| HICKEY PATRICK E | Agent | 107 MCMULLEN BOOTH ROAD NORTH, CLEARWATER, FL, 33759 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | - | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2010-04-30 |
| ANNUAL REPORT | 2009-04-27 |
| ANNUAL REPORT | 2008-09-13 |
| Florida Limited Liability | 2007-08-01 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
