| Entity Name: | RUSSELL EMERGENCY PHYSICIANS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 12 Nov 2013 (11 years ago) |
| Date of dissolution: | 03 Jun 2024 (8 months ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 03 Jun 2024 (8 months ago) |
| Document Number: | L13000159178 |
| FEI/EIN Number | 75-2758839 |
| Address: | 20 Burton Hills Blvd, Suite 500, NASHVILLE, TN 37215 |
| Mail Address: | 20 Burton Hills Blvd, Suite 500, NASHVILLE, TN 37215 |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245289180 | 2006-05-08 | 2013-12-24 | 13737 NOEL RD, STE 1600, DALLAS, TX, 752401331, US | 201 14TH ST SW, LARGO, FL, 337703133, US | |||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||
| Phone | +1 469-401-2386 |
| Phone | +1 727-588-5222 |
| Fax | 7275885458 |
Authorized person
| Name | GREGORY BYRNE |
| Role | PRESIDENT |
| Phone | 4694012386 |
Taxonomy
| Taxonomy Code | 207P00000X - Emergency Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 264169100 |
| State | FL |
| Issuer | BLUE SHIELD |
| Number | 21749 |
| State | FL |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role | Address |
|---|---|---|
| BYRNE, M.D., GREGORY J. | Manager | 20 Burton Hills Blvd, Suite 500 NASHVILLE, TN 37215 |
| Name | Role | Address |
|---|---|---|
| BYRNE, M.D., GREGORY J. | President | 20 Burton Hills Blvd, Suite 500 NASHVILLE, TN 37215 |
| Name | Role | Address |
|---|---|---|
| BYRNE, M.D., GREGORY J. | Secretary | 20 Burton Hills Blvd, Suite 500 NASHVILLE, TN 37215 |
| Name | Role | Address |
|---|---|---|
| BYRNE, M.D., GREGORY J. | Treasurer | 20 Burton Hills Blvd, Suite 500 NASHVILLE, TN 37215 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2024-06-03 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-19 | 20 Burton Hills Blvd, Suite 500, NASHVILLE, TN 37215 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-19 | 20 Burton Hills Blvd, Suite 500, NASHVILLE, TN 37215 | No data |
| CONVERSION | 2013-11-12 | No data | GEN-COR CONVERSION RESULT. THE CONVERTING ENTITY WAS GP1300001591 ORIGINALLY FILED ON 11/08/2013. CONVERSION NUMBER 900000135969 |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2024-06-03 |
| ANNUAL REPORT | 2024-04-19 |
| ANNUAL REPORT | 2023-04-25 |
| ANNUAL REPORT | 2022-04-29 |
| ANNUAL REPORT | 2021-04-29 |
| ANNUAL REPORT | 2020-06-28 |
| ANNUAL REPORT | 2019-04-23 |
| ANNUAL REPORT | 2018-04-24 |
| ANNUAL REPORT | 2017-04-27 |
| ANNUAL REPORT | 2016-04-27 |
Date of last update: 22 Jan 2025
Sources: Florida Department of State
