| Entity Name: | PINELLAS PSYCHIATRIC SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 16 Apr 2012 (13 years ago) |
| Date of dissolution: | 26 Sep 2014 (10 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2014 (10 years ago) |
| Document Number: | L12000051421 |
| FEI/EIN Number | 90-0826224 |
| Address: | 25 FRANKLIN COURT SOUTH, UNIT A, ST. PETERSBURG, FL, 33711 |
| Mail Address: | P.O. BOX 11957, ST. PETERSBURG, FL, 33733 |
| ZIP code: | 33711 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295075372 | 2013-02-26 | 2013-02-26 | 25 FRANKLIN CT S, UNIT A, ST PETERSBURG, FL, 337115136, US | 25 FRANKLIN CT S, UNIT A, ST PETERSBURG, FL, 337115136, US | |||||||||||||||||||||||
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| Phone | +1 727-385-4455 |
Authorized person
| Name | BERNY EXCELLENT |
| Role | OWNER |
| Phone | 7273854455 |
Taxonomy
| Taxonomy Code | 103TP0016X - Prescribing (Medical) Psychologist |
| License Number | ME 58124 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | FLORIDA MEDICAL LICENSE |
| Number | ME 58124 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| EXCELLENT BERNY M | Agent | 25 FRANKLIN COURT SOUTH, ST. PETERSBURG, FL, 33711 |
| Name | Role | Address |
|---|---|---|
| EXCELLENT BERNY M | Managing Member | 25 FRANKLIN COURT SOUTH, UNIT A, ST. PETERSBURG, FL, 33711 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| LC AMENDMENT AND NAME CHANGE | 2013-01-02 | PINELLAS PSYCHIATRIC SERVICES, LLC | No data |
| CHANGE OF MAILING ADDRESS | 2013-01-02 | 25 FRANKLIN COURT SOUTH, UNIT A, ST. PETERSBURG, FL 33711 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2013-01-03 |
| LC Amendment and Name Change | 2013-01-02 |
| Florida Limited Liability | 2012-04-16 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
