| Entity Name: | PATIENT PHYSICIAN SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 19 May 2017 (8 years ago) |
| Date of dissolution: | 28 Sep 2018 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2018 (6 years ago) |
| Document Number: | L17000111900 |
| Address: | 14100 U.S. HIGHWAY 19 NORTH, SUITE 132, LARGO, FL, 33764 |
| Mail Address: | 14100 U.S. HIGHWAY 19 NORTH, SUITE 132, LARGO, FL, 33764 |
| ZIP code: | 33764 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073033940 | 2017-06-22 | 2022-07-21 | 14100 US HIGHWAY 19 N STE 132, CLEARWATER, FL, 337647220, US | 14100 US HIGHWAY 19 N STE 132, CLEARWATER, FL, 337647220, US | |||||||||||||||||||||||
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| Phone | +1 727-954-7642 |
| Fax | 7278989596 |
Authorized person
| Name | BARBARA JEANNE HOPKINS-HOCKMAN |
| Role | OFFICE MANAGER |
| Phone | 7279547642 |
Taxonomy
| Taxonomy Code | 2081P2900X - Pain Medicine (Physical Medicine & Rehabilitation) Physician |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| KUTCHINS BRYAN AESQUIRE | Agent | 3974 TAMPA ROAD, OLDSMAR, FL, 34677 |
| Name | Role | Address |
|---|---|---|
| LOCKETT RICKY PD.O. | Manager | 1501 5TH AVENUE NORTH, ST. PETERSBURG, FL, 33705 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| Name | Date |
|---|---|
| Florida Limited Liability | 2017-05-19 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
