| Entity Name: | SOUND PHYSICIANS OF FLORIDA IV, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 23 Jun 2016 (9 years ago) |
| Document Number: | L16000121414 |
| FEI/EIN Number | 38-4008024 |
| Address: | 120 Brentwood Commons Way, Ste. 510, Brentwood, TN, 37027, US |
| Mail Address: | 120 Brentwood Commons Way, Ste. 510, Brentwood, TN, 37027, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1235712415 | 2021-05-04 | 2021-05-04 | 5410 MARYLAND WAY STE 300, BRENTWOOD, TN, 370275339, US | 3100 E FLETCHER AVE, TAMPA, FL, 336134613, US | |||||||||||||||||||||
|
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| Phone | +1 615-577-6340 |
| Phone | +1 813-971-6000 |
Authorized person
| Name | MELISSA HARLAN |
| Role | DIRECTOR |
| Phone | 6155776340 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 019146701 |
| State | FL |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role | Address |
|---|---|---|
| Birkmeyer John | President | 120 Brentwood Commons Way, Brentwood, TN, 37027 |
| Name | Role | Address |
|---|---|---|
| Templer Michael | Treasurer | 120 Brentwood Commons Way, Brentwood, TN, 37027 |
| Name | Role | Address |
|---|---|---|
| Klug Nicole | Secretary | 120 Brentwood Commons Way, Brentwood, TN, 37027 |
| Name | Role | Address |
|---|---|---|
| Vaughan Lindsey | Asst | 120 Brentwood Commons Way, Brentwood, TN, 37027 |
| Name | Role | Address |
|---|---|---|
| Alter Jeff | Director | 120 Brentwood Commons Way, Brentwood, TN, 37027 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-04-29 | 120 Brentwood Commons Way, Ste. 510, Brentwood, TN 37027 | No data |
| CHANGE OF MAILING ADDRESS | 2022-04-29 | 120 Brentwood Commons Way, Ste. 510, Brentwood, TN 37027 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-17 |
| ANNUAL REPORT | 2023-04-25 |
| ANNUAL REPORT | 2022-04-29 |
| ANNUAL REPORT | 2021-04-29 |
| ANNUAL REPORT | 2020-01-02 |
| ANNUAL REPORT | 2019-04-15 |
| ANNUAL REPORT | 2018-04-10 |
| ANNUAL REPORT | 2017-05-01 |
| Florida Limited Liability | 2016-06-23 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
