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BLUESTONE PHYSICIAN SERVICES SOUTHEAST, LLC - Florida Company Profile

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Company Details

Entity Name: BLUESTONE PHYSICIAN SERVICES SOUTHEAST, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

BLUESTONE PHYSICIAN SERVICES SOUTHEAST, 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.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act

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 Mar 2015 (10 years ago)
Last Event: LC NAME CHANGE
Event Date Filed: 10 Aug 2020 (5 years ago)
Document Number: L15000066178
FEI/EIN Number 59-3568197

Federal Employer Identification (FEI) Number assigned by the IRS.

Mail Address: 10150 Highland Manor Drive, TAMPA, FL, 33610, US
Address: 10150 HIGHLAND MANOR DRIVE, TAMPA, FL, 33610, US
ZIP code: 33610
City: Tampa
County: Hillsborough
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
Nelsen David Chief Financial Officer 270 North Main Street, Stillwater, MN, 55082
PATEL RAJIV Chief Executive Officer 270 North Main Street, Stillwater, MN, 55082
PATEL RAJIV Agent 10150 Highland Manor Drive, TAMPA, FL, 33610

National Provider Identifier

NPI Number:
1346212370
Certification Date:
2024-02-07

Authorized Person:

Name:
DIANA BERNARD I
Role:
OFFICE MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
8132540396

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2025-02-10 PATEL, RAJIV -
REGISTERED AGENT NAME CHANGED 2022-01-17 STIVLAND, TODD -
LC NAME CHANGE 2020-08-10 BLUESTONE PHYSICIAN SERVICES SOUTHEAST, LLC -
LC STMNT CORR 2020-01-27 - -
CHANGE OF PRINCIPAL ADDRESS 2019-04-19 10150 HIGHLAND MANOR DRIVE, TAMPA, FL 33610 -
CHANGE OF MAILING ADDRESS 2019-04-19 10150 HIGHLAND MANOR DRIVE, TAMPA, FL 33610 -
REGISTERED AGENT ADDRESS CHANGED 2019-04-19 10150 Highland Manor Drive, TAMPA, FL 33610 -
LC AMENDMENT 2015-05-15 - -
MERGER 2015-05-11 - CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 1. MERGER NUMBER 100000151571

Documents

Name Date
ANNUAL REPORT 2025-02-10
ANNUAL REPORT 2024-02-12
ANNUAL REPORT 2023-02-11
ANNUAL REPORT 2022-01-17
ANNUAL REPORT 2021-01-22
LC Name Change 2020-08-10
ANNUAL REPORT 2020-02-05
CORLCSTCOR 2020-01-27
ANNUAL REPORT 2019-04-19
ANNUAL REPORT 2018-03-06

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Date of last update: 03 Jul 2025

Sources: Florida Department of State