| Entity Name: | DEERFIELD BEACH PHYSICIAN SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 19 Jul 2016 (9 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 13 Jun 2022 (3 years ago) |
| Document Number: | L16000135910 |
| FEI/EIN Number | 81-3362215 |
| 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 | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1366100364 | 2021-12-07 | 2022-09-27 | 200 CORPORATE BLVD, LAFAYETTE, LA, 705083870, US | 2626 CAPITAL MEDICAL BLVD, TALLAHASSEE, FL, 323084402, US | |||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||
| Phone | +1 800-893-9698 |
| Phone | +1 850-325-5000 |
| Fax | 8506565198 |
Authorized person
| Name | LISHA C FALK |
| Role | VP OF CONTRACTING |
| Phone | 3376091221 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 208M00000X - Hospitalist Physician |
| Is Primary | No |
| Taxonomy Code | 363A00000X - Physician Assistant |
| Is Primary | No |
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | No |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| SCHILLINGER DAVID MD | Authorized Member | 200 CORPORATE BOULEVARD, LAFAYETTE, LA, 70508 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2022-06-13 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-08 |
| ANNUAL REPORT | 2023-01-25 |
| LC Amendment | 2022-06-13 |
| ANNUAL REPORT | 2022-02-23 |
| ANNUAL REPORT | 2021-02-05 |
| ANNUAL REPORT | 2020-02-04 |
| ANNUAL REPORT | 2019-03-22 |
| ANNUAL REPORT | 2018-03-06 |
| ANNUAL REPORT | 2017-03-22 |
| Florida Limited Liability | 2016-07-19 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
