| Entity Name: | BARBARA A. DZIUBINSKI, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 30 May 2017 (8 years ago) |
| Date of dissolution: | 01 Sep 2021 (3 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 01 Sep 2021 (3 years ago) |
| Document Number: | L17000117899 |
| FEI/EIN Number | 82-1726999 |
| Address: | 12050 94TH STREET, LARGO, FL, 33773, US |
| Mail Address: | 12050 94TH STREET, LARGO, FL, 33773, US |
| ZIP code: | 33773 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1902326085 | 2017-06-21 | 2017-06-21 | 12050 94TH ST, LARGO, FL, 337734303, US | 9555 SEMINOLE BLVD STE 104, SEMINOLE, FL, 337722522, US | |||||||||||||||||||||||||||
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| Phone | +1 727-643-3037 |
| Fax | 8666321343 |
| Phone | +1 727-394-1500 |
Authorized person
| Name | BARBARA ANN DZIUBINSKI |
| Role | OWNER |
| Phone | 7276433037 |
Taxonomy
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| License Number | ARNP1072652 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 306054300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DZIUBINSKI BARBARA A | Agent | 12050 94TH STREET, LARGO, FL, 33773 |
| Name | Role | Address |
|---|---|---|
| DZIUBINSKI BARBARA A | Manager | 12050 94TH STREET, LARGO, FL, 33773 |
| Name | Role | Address |
|---|---|---|
| DZIUBINSKI IAN O | Authorized Member | 12050 94TH STREET, LARGO, FL, 33773 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2021-09-01 | No data | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2021-09-01 |
| ANNUAL REPORT | 2021-04-02 |
| ANNUAL REPORT | 2020-01-20 |
| ANNUAL REPORT | 2019-01-26 |
| ANNUAL REPORT | 2018-01-30 |
| Florida Limited Liability | 2017-05-30 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
