| Entity Name: | PATRICIA J. ANDERSON, MD, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 01 Dec 2008 (16 years ago) |
| Document Number: | L08000110236 |
| FEI/EIN Number | NOT APPLICABLE |
| Address: | 3001 West 10th Street, 411, Panama City, FL, 32401, US |
| Mail Address: | 83 Rocky Knob Court, 90, Burnsville, NC, 28714, US |
| ZIP code: | 32401 |
| County: | Bay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1134363120 | 2009-04-22 | 2009-04-22 | PO BOX 915, PANAMA CITY, FL, 324020915, US | 1847 FLORIDA AVE, PANAMA CITY, FL, 324054640, US | |||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||
| Phone | +1 850-914-8600 |
| Fax | 8507847706 |
Authorized person
| Name | DR. PATRICIA J ANDERSON |
| Role | PRESIDENT |
| Phone | 8509148600 |
Taxonomy
| Taxonomy Code | 207RN0300X - Nephrology Physician |
| License Number | ME82277 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | STATE OF FLORIDA LICENSE |
| Number | ME82277 |
| State | FL |
| Issuer | BCBS FLORIDA |
| Number | 58820 |
| State | FL |
| Issuer | MEDICAID |
| Number | 261089200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ANDERSON PATRICIA J | Agent | 3001 West 10th Street, Panama City, FL, 32401 |
| Name | Role | Address |
|---|---|---|
| Anderson Patricia J | President | 3001 West 10th Street, Panama City, FL, 32401 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-28 | 3001 West 10th Street, 411, Panama City, FL 32401 | No data |
| CHANGE OF MAILING ADDRESS | 2024-03-28 | 3001 West 10th Street, 411, Panama City, FL 32401 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-03-28 | 3001 West 10th Street, 411, Panama City, FL 32401 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-28 |
| ANNUAL REPORT | 2023-01-25 |
| ANNUAL REPORT | 2022-02-09 |
| ANNUAL REPORT | 2021-02-01 |
| ANNUAL REPORT | 2020-03-20 |
| ANNUAL REPORT | 2019-09-18 |
| ANNUAL REPORT | 2018-01-24 |
| ANNUAL REPORT | 2017-02-14 |
| ANNUAL REPORT | 2016-03-11 |
| ANNUAL REPORT | 2015-02-24 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
