| Entity Name: | COLLIER BOULEVARD HMA PHYSICIAN MANAGEMENT, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
COLLIER BOULEVARD HMA PHYSICIAN MANAGEMENT, 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: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 30 Jun 2009 (16 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 25 Feb 2014 (11 years ago) |
| Document Number: | L09000063303 |
| FEI/EIN Number |
270520049
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 4000 Meridian Boulevard, Franklin, TN, 37067, US |
| Mail Address: | 4000 Meridian Boulevard, Franklin, TN, 37067, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1164181277 | 2021-12-16 | 2022-03-09 | PO BOX 689022, FRANKLIN, TN, 370689022, US | 1285 CREEKSIDE BLVD E, NAPLES, FL, 341090590, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 615-465-7211 |
| Fax | 8778929815 |
| Phone | +1 239-348-4221 |
| Fax | 2395291850 |
Authorized person
| Name | JENNIFER L JACKSON |
| Role | SR DIR ONBOARDING & PROV ENROLLMENT |
| Phone | 6154653334 |
Taxonomy
| Taxonomy Code | 207RC0000X - Cardiovascular Disease Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | PENDING |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Hammons Kevin J | Manager | 4000 Meridian Boulevard, Franklin, TN, 37067 |
| Pitt Justin D | Manager | 4000 Meridian Boulevard, Franklin, TN, 37067 |
| Cash W. B | Manager | 4000 Meridian Boulevard, Franklin, TN, 37067 |
| CORPORATION SERVICE COMPANY | Agent | - |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000091342 | PHYSICIANS REGIONAL MEDICAL GROUP | ACTIVE | 2018-08-16 | 2028-12-31 | - | 4000 MERIDIAN BLVD., FRANKLIN, TN, 37067 |
| G13000015087 | PHYSICIANS REGIONAL MARCO ISLAND | ACTIVE | 2013-02-12 | 2028-12-31 | - | 4000 MERIDIAN BLVD., FRANKLIN, TN, 37067 |
| G12000010992 | COMPLETE WOMEN'S CARE OF NAPLES | EXPIRED | 2012-02-01 | 2017-12-31 | - | 8340 COLLIER BOULEVARD, SUITE 301, NAPLES, FL, 34114 |
| G11000122855 | PHYSICIANS REGIONAL MEDICAL GROUP | EXPIRED | 2011-12-16 | 2016-12-31 | - | 5811 PELICAN BAY BOULEVARD, SUITE 500, NAPLES, FL, 34108 |
| G09000167947 | COLLIER REGIONAL MEDICAL GROUP | EXPIRED | 2009-10-22 | 2014-12-31 | - | 5811 PELICAN BAY BOULEVARD, ATTN: LEGAL DEPT, NAPLES, FL, 34108 |
| G09000165135 | CARNEIRO INSTITUTE FOR HAND SURGERY | EXPIRED | 2009-10-14 | 2014-12-31 | - | 5811 PELICAN BAY BOULEVARD #500, ATTN: LEGAL DEPT, NAPLES, FL, 34108 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2019-04-25 | 4000 Meridian Boulevard, Franklin, TN 37067 | - |
| CHANGE OF MAILING ADDRESS | 2019-04-25 | 4000 Meridian Boulevard, Franklin, TN 37067 | - |
| LC STMNT OF RA/RO CHG | 2014-02-25 | - | - |
| REGISTERED AGENT NAME CHANGED | 2014-02-25 | CORPORATION SERVICE COMPANY | - |
| REGISTERED AGENT ADDRESS CHANGED | 2014-02-25 | 1201 HAYS STREET, TALLAHASSEE, FL 32301-2525 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-25 |
| ANNUAL REPORT | 2023-04-12 |
| ANNUAL REPORT | 2022-04-23 |
| ANNUAL REPORT | 2021-04-23 |
| ANNUAL REPORT | 2020-04-15 |
| ANNUAL REPORT | 2019-04-25 |
| ANNUAL REPORT | 2018-04-21 |
| ANNUAL REPORT | 2017-04-18 |
| ANNUAL REPORT | 2016-04-22 |
| ANNUAL REPORT | 2015-04-21 |
Date of last update: 01 Mar 2025
Sources: Florida Department of State
