| Entity Name: | PHCA ADMINISTRATION, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 30 Aug 2016 (8 years ago) |
| Document Number: | L16000162512 |
| FEI/EIN Number | 81-3700487 |
| Address: | 720 Brooker Creek Blvd., Suite 215, Oldsmar, FL 34677 |
| Mail Address: | 720 Brooker Creek Blvd., Suite 215, Oldsmar, FL 34677 |
| ZIP code: | 34677 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1487187571 | 2017-04-06 | 2017-04-06 | 4033 TAMPA RD, SUITE 101, OLDSMAR, FL, 346773224, US | 4033 TAMPA RD, SUITE 101, OLDSMAR, FL, 346773224, US | |||||||||||||||
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| Phone | +1 813-854-2003 |
| Fax | 8138552367 |
Authorized person
| Name | DEBRA S GONZALEZ |
| Role | PHCA ADMINISTRATION, LLC, C.O.O. |
| Phone | 8138542003 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| RUGG, JOSEPH | Agent | Chestnut Business Services, LLC, 911 Chestnut Street, Clearwater, FL 33756 |
| Name | Role | Address |
|---|---|---|
| KULEK-LUZEY, KARALEE, M.D. | Manager | 720 Brooker Creek Blvd., Suite 215 Oldsmar, FL 34677 |
| FERRELLI, RICHARD | Manager | 720 Brooker Creek Blvd., Suite 215 Oldsmar, FL 34677 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-04-20 | 720 Brooker Creek Blvd., Suite 215, Oldsmar, FL 34677 | No data |
| CHANGE OF MAILING ADDRESS | 2022-04-20 | 720 Brooker Creek Blvd., Suite 215, Oldsmar, FL 34677 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-02-14 | Chestnut Business Services, LLC, 911 Chestnut Street, Clearwater, FL 33756 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-13 |
| ANNUAL REPORT | 2023-01-24 |
| ANNUAL REPORT | 2022-04-20 |
| ANNUAL REPORT | 2021-02-04 |
| ANNUAL REPORT | 2020-03-04 |
| ANNUAL REPORT | 2019-02-14 |
| ANNUAL REPORT | 2018-02-08 |
| ANNUAL REPORT | 2017-03-23 |
| Florida Limited Liability | 2016-08-30 |
Date of last update: 19 Jan 2025
Sources: Florida Department of State
