| Entity Name: | ROCKLEDGE PHYSICIAN SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 18 Mar 2016 (9 years ago) |
| Document Number: | L16000056018 |
| FEI/EIN Number | 81-1963953 |
| Address: | 200 CORPORATE BLVD, LAFAYETTE, LA, 70508 |
| Mail Address: | 200 CORPORATE BLVD, LAFAYETTE, LA, 70508 |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538523295 | 2016-04-08 | 2021-05-17 | 200 CORPORATE BLVD, LAFAYETTE, LA, 705083870, US | 110 LONGWOOD AVE, ROCKLEDGE, FL, 329552828, US | |||||||||||||||||||||||||||||
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| Phone | +1 800-893-9698 |
| Phone | +1 321-636-2211 |
Authorized person
| Name | LISHA FALK |
| Role | VP OF CONTRACTING |
| Phone | 8008939698 |
Taxonomy
| Taxonomy Code | 208M00000X - Hospitalist Physician |
| Is Primary | Yes |
| Taxonomy Code | 363A00000X - Physician Assistant |
| Is Primary | No |
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 017402700 |
| State | FL |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role |
|---|---|
| THE SCHUMACHER GROUP OF FLORIDA, INC. | Authorized Member |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-14 |
| ANNUAL REPORT | 2023-02-09 |
| ANNUAL REPORT | 2022-03-23 |
| ANNUAL REPORT | 2021-01-29 |
| ANNUAL REPORT | 2020-02-27 |
| ANNUAL REPORT | 2019-03-22 |
| ANNUAL REPORT | 2018-03-06 |
| ANNUAL REPORT | 2017-03-24 |
| Florida Limited Liability | 2016-03-18 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
