| Entity Name: | NIKIA .L. PHILLIPS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 23 Feb 2017 (8 years ago) |
| Document Number: | L17000042750 |
| FEI/EIN Number | 820914016 |
| Address: | 1397 MEDICAL PARK BLVD, Wellington, FL, 33414, US |
| Mail Address: | 3108 BREAKWATER COURT, WEST PALM BEACH, FL, 33411, US |
| ZIP code: | 33414 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1821539289 | 2017-03-17 | 2020-10-05 | 1397 MEDICAL PARK BLVD STE 140, WELLINGTON, FL, 334143187, US | 1397 MEDICAL PARK BLVD STE 140, WELLINGTON, FL, 334143187, US | |||||||||||||||||||||||||||
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| Phone | +1 561-508-3989 |
| Fax | 5616318872 |
Authorized person
| Name | NIKIA PHILLIPS |
| Role | OWNER/PROVIDER |
| Phone | 5615083989 |
Taxonomy
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| License Number | ARNP9191977 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 367A00000X - Advanced Practice Midwife |
| License Number | CNM2261 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| PHILLIPS NIKIA L | Agent | 3108 BREAKWATER COURT, WEST PALM BEACH, FL, 33411 |
| Name | Role | Address |
|---|---|---|
| PHILLIPS NIKIA L | Manager | 3108 BREAKWATER COURT, WEST PALM BEACH, FL, 33411 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000128801 | NP FAMILY PRACTICE & MIDWIFERY CARE | ACTIVE | 2020-10-04 | 2025-12-31 | No data | 3108 BREAKWATER COURT, WEST PALM BEACH, FL, 33411 |
| G17000116389 | NP FAMILY PRACTICE | EXPIRED | 2017-10-23 | 2022-12-31 | No data | 3319 STATE ROAD 7 SUITE 106, WELLINGTON, FL, 33449 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-02-08 | 1397 MEDICAL PARK BLVD, Suite 140, Wellington, FL 33414 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-11 |
| ANNUAL REPORT | 2023-04-03 |
| ANNUAL REPORT | 2022-04-04 |
| ANNUAL REPORT | 2021-02-08 |
| ANNUAL REPORT | 2020-04-19 |
| ANNUAL REPORT | 2019-04-11 |
| ANNUAL REPORT | 2018-03-31 |
| Florida Limited Liability | 2017-02-23 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
