| Entity Name: | HARBORSIDE PSYCHIATRIC SERVICES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 17 Dec 2007 (17 years ago) |
| Date of dissolution: | 13 Dec 2021 (3 years ago) |
| Last Event: | LC RA/RO CHG FOR INACTIVES |
| Event Date Filed: | 13 Dec 2021 (3 years ago) |
| Document Number: | L07000124924 |
| FEI/EIN Number | 261616989 |
| Address: | 150 McKenzie Street, SUITE # 117, PUNTA GORDA, FL, 33950, US |
| Mail Address: | 150 McKenzie St., Suite 117, PUNTA GORDA, FL, 33950, US |
| ZIP code: | 33950 |
| County: | Charlotte |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1972788669 | 2008-01-01 | 2018-05-17 | 150 W. MCKENZIE STREET, SUITE #117, PUNTA GORDA, FL, 339505500, US | 150 W. MCKENZIE STREET, SUITE #117, PUNTA GORDA, FL, 33950, US | |||||||||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 941-205-3333 |
| Fax | 9412053334 |
Authorized person
| Name | MS. JOAN E. FLYNN |
| Role | PARTNER |
| Phone | 9412053333 |
Taxonomy
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| License Number | SW7783 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 2084N0400X - Neurology Physician |
| License Number | L07000124924 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| License Number | ME86547 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| License Number | L07000124924 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 266691001 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FLYNN JOAN | Agent | 25516 HERITAGE LAKE BOULEVARD, PUNTA GORDA, FL, 33950 |
| Name | Role | Address |
|---|---|---|
| Sarma Suresh Dr. | Manager | 150 McKenzie St., PUNTA GORDA, FL, 33950 |
| FLYNN JOAN E | Manager | 25516 HERITAGE LAKE BOULEVARD, PUNTA GORDA, FL, 33983 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2021-12-13 | 25516 HERITAGE LAKE BOULEVARD, PUNTA GORDA, FL 33950 | No data |
| LC STMNT OF RA/RO CHG | 2021-12-13 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2021-12-13 | FLYNN, JOAN | No data |
| VOLUNTARY DISSOLUTION | 2020-04-22 | No data | No data |
| LC AMENDMENT | 2018-10-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-01-05 | 150 McKenzie Street, SUITE # 117, PUNTA GORDA, FL 33950 | No data |
| CHANGE OF MAILING ADDRESS | 2018-01-05 | 150 McKenzie Street, SUITE # 117, PUNTA GORDA, FL 33950 | No data |
| REINSTATEMENT | 2008-10-27 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2008-09-26 | No data | No data |
| Name | Date |
|---|---|
| CORLCRACHI | 2021-12-13 |
| VOLUNTARY DISSOLUTION | 2020-04-22 |
| AMENDED ANNUAL REPORT | 2019-11-13 |
| AMENDED ANNUAL REPORT | 2019-10-31 |
| AMENDED ANNUAL REPORT | 2019-04-08 |
| ANNUAL REPORT | 2019-02-20 |
| AMENDED ANNUAL REPORT | 2018-11-07 |
| LC Amendment | 2018-10-25 |
| ANNUAL REPORT | 2018-01-05 |
| ANNUAL REPORT | 2017-02-11 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
