| Entity Name: | PHYSICIAN PARTNERS SPECIALTY SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 28 Dec 2012 (12 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 26 Jul 2023 (a year ago) |
| Document Number: | L12000161411 |
| FEI/EIN Number | 46-1663163 |
| Mail Address: | 601 S HARBOUR ISLAND BLVD, SUITE 200, TAMPA, FL 33602 |
| Address: | 1714 SW 17TH STREET, OCALA, FL 34471 |
| ZIP code: | 34471 |
| County: | Marion |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1356688899 | 2013-01-03 | 2023-02-06 | 1714 SW 17TH ST, OCALA, FL, 344711227, US | 1714 SW 17TH ST, OCALA, FL, 344711223, US | |||||||||||||||||||||||||||||||||||
|
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| Phone | +1 352-274-9455 |
| Fax | 8774050955 |
| Phone | +1 352-274-9900 |
| Fax | 3522610816 |
Authorized person
| Name | SRIRAM SUNDARAMOORTHY |
| Role | CHIEF COMPLIANCE OFFICER |
| Phone | 8134445838 |
Taxonomy
| Taxonomy Code | 207RC0000X - Cardiovascular Disease Physician |
| Is Primary | No |
| Taxonomy Code | 207RE0101X - Endocrinology, Diabetes & Metabolism Physician |
| Is Primary | Yes |
| Taxonomy Code | 207X00000X - Orthopaedic Surgery Physician |
| Is Primary | No |
| Taxonomy Code | 208M00000X - Hospitalist Physician |
| Is Primary | No |
| Taxonomy Code | 213E00000X - Podiatrist |
| Is Primary | No |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| PAGIDIPATI, RUDRAMA MD | Managing Member | 601 S HARBOUR ISLAND BLVD, SUITE 200 TAMPA, FL 33602 |
| Name | Role | Address |
|---|---|---|
| PAGIDIPATI, SIDD | Manager | 601 S HARBOUR ISLAND BLVD, SUITE 200 TAMPA, FL 33602 |
| PAGIDIPATI, RAHUL | Manager | 601 S HARBOUR ISLAND BLVD, SUITE 200 TAMPA, FL 33602 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G14000010582 | PHYSICIAN PARTNERS SPECIALISTS | EXPIRED | 2014-01-30 | 2019-12-31 | No data | 2955 SE 3RD COURT, OCALA, FL, 34471 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-02-13 | 1714 SW 17TH STREET, OCALA, FL 34471 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-07-26 | C T CORPORATION SYSTEM | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-07-26 | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 | No data |
| LC STMNT OF RA/RO CHG | 2023-07-26 | No data | No data |
| REINSTATEMENT | 2023-01-03 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-04-27 | 1714 SW 17TH STREET, OCALA, FL 34471 | No data |
| LC AMENDMENT AND NAME CHANGE | 2015-04-27 | PHYSICIAN PARTNERS SPECIALTY SERVICES, LLC | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-13 |
| CORLCRACHG | 2023-07-26 |
| REINSTATEMENT | 2023-01-03 |
| ANNUAL REPORT | 2021-01-29 |
| ANNUAL REPORT | 2020-01-14 |
| ANNUAL REPORT | 2019-03-29 |
| ANNUAL REPORT | 2018-02-08 |
| ANNUAL REPORT | 2017-03-12 |
| ANNUAL REPORT | 2016-03-12 |
| LC Amendment and Name Change | 2015-04-27 |
Date of last update: 23 Jan 2025
Sources: Florida Department of State
