| Entity Name: | LIAN S. CHANG, MD, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 28 Feb 2008 (17 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 04 Oct 2021 (3 years ago) |
| Document Number: | L08000022065 |
| FEI/EIN Number | 800171435 |
| Address: | 17900 GULF BLVD, STE. 7A, REDINGTON SHORES, FL, 33708-1102, US |
| Mail Address: | 17900 GULF BLVD, STE. 7A, REDINGTON SHORES, FL, 33708-1102, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1417390204 | 2013-04-10 | 2013-04-10 | 17900 GULF BLVD APT 7A, REDINGTON SHORES, FL, 337081102, US | 17900 GULF BLVD APT 7A, REDINGTON SHORES, FL, 337081102, US | |||||||||||||||||||||||||
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| Phone | +1 651-408-3978 |
| Fax | 6516367273 |
Authorized person
| Name | LIAN CHANG |
| Role | OWNER |
| Phone | 6516280368 |
Taxonomy
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | ME98853 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE PTAN |
| Number | AK187 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GRECO FRANK J | Agent | 143 E DAVIS BLVD, TAMPA, FL, 33606 |
| Name | Role | Address |
|---|---|---|
| CHANG LIAN SDr. | Managing Member | 17900 GULF BLVD, STE. 7A, REDINGTON SHORES, FL, 337081102 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2022-07-16 | 143 E DAVIS BLVD, Unit 4, TAMPA, FL 33606 | No data |
| LC STMNT OF RA/RO CHG | 2021-10-04 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2021-10-04 | GRECO, FRANK J | No data |
| CANCEL ADM DISS/REV | 2009-11-03 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-02 |
| ANNUAL REPORT | 2023-03-10 |
| ANNUAL REPORT | 2022-07-16 |
| CORLCRACHG | 2021-10-04 |
| ANNUAL REPORT | 2021-01-10 |
| ANNUAL REPORT | 2020-01-19 |
| ANNUAL REPORT | 2019-02-06 |
| ANNUAL REPORT | 2018-01-10 |
| ANNUAL REPORT | 2017-01-11 |
| ANNUAL REPORT | 2016-01-22 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
