| Entity Name: | KPW HEALTH LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 19 Feb 2018 (7 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 10 Jun 2024 (8 months ago) |
| Document Number: | L18000044851 |
| FEI/EIN Number | 82-4467054 |
| Address: | 7044 Brier Creek Ct, Lakewood Ranch, FL 34202 |
| Mail Address: | 7044 Brier Creek Ct, Lakewood Ranch, FL 34202 |
| ZIP code: | 34202 |
| County: | Manatee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1427559020 | 2018-02-28 | 2024-09-19 | 900 CARILLON PKWY STE 301, ST PETERSBURG, FL, 337161115, US | 900 CARILLON PKWY STE 301, ST PETERSBURG, FL, 337161115, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 727-230-3423 |
| Fax | 2176363056 |
Authorized person
| Name | KHALILAH WESTON |
| Role | OWNER |
| Phone | 7346575407 |
Taxonomy
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | HUMANA, INC |
| Number | 61101 |
| Issuer | MEDICAID |
| Number | MC010 |
| State | FL |
| Issuer | WELLCARE FLORIDA |
| Number | 14163 |
| Issuer | UMR |
| Number | 39026 |
| Issuer | AVEMED HEALTH PLAN |
| Number | 59274 |
| Issuer | CIGNA |
| Number | 62308 |
| Issuer | MERITAIN HEALTH |
| Number | 64157 |
| Issuer | GHI/EMBLEM HEALTH PLAN |
| Number | 13551 |
| Issuer | AMERIGROUP |
| Number | 28804 |
| Issuer | SUNSHINE MEDICAID |
| Number | 68069 |
| Issuer | WELLMED/UNITED HEALTH CARE |
| Number | WELLM2 |
| Issuer | COVENTRY HEALTH CARE |
| Number | 25133 |
| Issuer | AARP- UHC OVATIONS INSURANCE SOLUTIONS |
| Number | 36273 |
| Issuer | GOLDEN RULE INSURANCE PLAN |
| Number | 37602 |
| Issuer | CHAMPVA |
| Number | 80214 |
| Issuer | BLUE SHIELD FLORIDA |
| Number | BS022 |
| Issuer | OPTIMUM INSURANCE PLAN |
| Number | 20133 |
| Issuer | FREEDOM HEALTH INSURANCE PLAN |
| Number | 41212 |
| Issuer | GEHA |
| Number | 44054 |
| Issuer | TPA |
| Number | 75261 |
| Issuer | UNITED HEALTH CARE |
| Number | 87726 |
| Issuer | OXFORD HEALTH PLAN |
| Number | 06111 |
| Issuer | SIMPLY HEALTH CARE/ CLEAR HEALTH ALLIANCE |
| Number | 27094 |
| Issuer | PRESTIGE |
| Number | 77003 |
| Issuer | HEALTH FIRST HEALTH PLANS |
| Number | 95019 |
| Issuer | STAYWELL HEALTH PLAN |
| Number | 14163 |
| Issuer | AETNA |
| Number | 60054 |
| Issuer | AETNA MEDICARE |
| Number | 60054 |
| Issuer | GREAT WEST PPO |
| Number | 62308 |
| Name | Role | Address |
|---|---|---|
| WESTON, KHALILAH M, MD | Agent | 900 Carillon Pkwy, Suite 301, SAINT PETERSBURG, FL 33716 |
| Name | Role | Address |
|---|---|---|
| WESTON, KHALILAH M, MD | Manager | 505 GILMAN CT N, ST PETERSBURG, FL 33716 |
| WESTON, PATRICK S, MD | Manager | 505 GILMAN CT N, ST PETERSBURG, FL 33716 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2025-01-31 | 900 Carillon Pkwy, Suite 301, SAINT PETERSBURG, FL 33716 | No data |
| REINSTATEMENT | 2024-06-10 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2024-06-10 | WESTON, KHALILAH M, MD | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-03-07 | 603 7th St S, Suite 540, SAINT PETERSBURG, FL 33701 | No data |
| CHANGE OF MAILING ADDRESS | 2021-01-03 | 7044 Brier Creek Ct, Lakewood Ranch, FL 34202 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-01-03 | 7044 Brier Creek Ct, Lakewood Ranch, FL 34202 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-31 |
| REINSTATEMENT | 2024-06-10 |
| ANNUAL REPORT | 2022-03-07 |
| ANNUAL REPORT | 2021-01-03 |
| ANNUAL REPORT | 2020-01-14 |
| ANNUAL REPORT | 2019-04-01 |
| Florida Limited Liability | 2018-02-19 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 4441587400 | 2020-05-09 | 0455 | PPP | 505 GILMAN CT N, SAINT PETERSBURG, FL, 33716-1310 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 17 Feb 2025
Sources: Florida Department of State
