| Entity Name: | QUALITY OF LIFE DME, LIMITED LIABILITY COMPANY |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 16 Nov 2017 (7 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: | L17000237696 |
| Address: | 1501 5TH AVENUE NORTH, ST PETERSBURG, FL, 33705, US |
| Mail Address: | 1501 5TH AVENUE NORTH, ST PETERSBURG, FL, 33705, US |
| ZIP code: | 33705 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1093221798 | 2017-12-18 | 2018-06-16 | 1501 5TH AVE N, ST PETERSBURG, FL, 337052008, US | 1501 5TH AVE N, ST PETERSBURG, FL, 337052008, US | |||||||||||||||||||||||||
|
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| Phone | +1 727-485-8780 |
| Fax | 8558169860 |
Authorized person
| Name | DR. RICKY P LOCKETT |
| Role | OWNER |
| Phone | 7278968686 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | OS6109 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 56170300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LOCKETT RICKY PDO | Agent | 2395 OLD COACH TRAIL, CLEARWATER, FL, 33765 |
| Name | Role | Address |
|---|---|---|
| LOCKETT RICKY PDO | Manager | 1501 5TH AVENUE NORTH, ST PETERSBURG, FL, 33705 |
| Name | Role | Address |
|---|---|---|
| HOPKINS-HOCKMAN BARBARA J | Authorized Representative | 1501 5TH AVENUE NORTH, ST PETERSBURG, FL, 33705 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2025-05-01 | 1501 5TH AVENUE NORTH, ST PETERSBURG, FL 33705 | No data |
| CHANGE OF MAILING ADDRESS | 2025-05-01 | 1501 5TH AVENUE NORTH, ST PETERSBURG, FL 33705 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| Name | Date |
|---|---|
| Florida Limited Liability | 2017-11-16 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
