| Entity Name: | QSS-SOUTHEAST CLINICAL SERVICES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
QSS-SOUTHEAST CLINICAL SERVICES 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: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 31 Jan 2013 (12 years ago) |
| Date of dissolution: | 22 Apr 2024 (a year ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 22 Apr 2024 (a year ago) |
| Document Number: | L13000017513 |
| FEI/EIN Number |
46-2080437
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 4215 Edgewater Drive, orlando, FL, 32804, US |
| Mail Address: | 4215 Edgewater Drive, orlando, FL, 32804, US |
| ZIP code: | 32804 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1740521137 | 2013-03-08 | 2023-07-07 | PO BOX 4095, WAYNE, NJ, 074704095, US | 4215 EDGEWATER DR, ORLANDO, FL, 328042206, US | |||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 973-826-8080 |
| Fax | 8663093354 |
| Phone | +1 407-539-2000 |
| Fax | 4073980050 |
Authorized person
| Name | CAREEN E WILSON |
| Role | MANAGER |
| Phone | 9738941263 |
Taxonomy
| Taxonomy Code | 208600000X - Surgery Physician |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 113496900 |
| State | FL |
| Issuer | UHC |
| Number | 3593907 |
| State | FL |
| Issuer | CIGNA |
| Number | 1740521137 |
| State | FL |
| Issuer | RR MEDICARE |
| Number | DU0724 |
| State | FL |
| Issuer | BLUE CROSS BLUE SHIELD OF FL |
| Number | 004AH |
| State | FL |
| Name | Role | Address |
|---|---|---|
| COHEN BARRY A | Manager | 4215 EDGEWATER DRIVE, ORLANDO, FL, 32804 |
| Byrnes John PAC | Clin | 4215 Edgewater Drive, orlando, FL, 32804 |
| KOLTUN JEFFREY M | Agent | 150 Spartan Drive, MAITLAND, FL, 32751 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2024-04-22 | - | - |
| REGISTERED AGENT ADDRESS CHANGED | 2024-03-04 | 150 Spartan Drive, SUITE 100, MAITLAND, FL 32751 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2023-03-28 | 4215 Edgewater Drive, orlando, FL 32804 | - |
| CHANGE OF MAILING ADDRESS | 2023-03-28 | 4215 Edgewater Drive, orlando, FL 32804 | - |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2024-04-22 |
| ANNUAL REPORT | 2024-03-04 |
| ANNUAL REPORT | 2023-01-27 |
| ANNUAL REPORT | 2022-07-14 |
| ANNUAL REPORT | 2021-03-15 |
| ANNUAL REPORT | 2020-02-05 |
| ANNUAL REPORT | 2019-02-07 |
| ANNUAL REPORT | 2018-01-15 |
| ANNUAL REPORT | 2017-01-11 |
| ANNUAL REPORT | 2016-03-03 |
Date of last update: 01 Apr 2025
Sources: Florida Department of State
