| Entity Name: | PRECISION HEALTH BY SCIENCE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 16 May 2018 (7 years ago) |
| Last Event: | LC AMENDMENT AND NAME CHANGE |
| Event Date Filed: | 27 Jul 2018 (7 years ago) |
| Document Number: | L18000122469 |
| FEI/EIN Number | 83-0638860 |
| Address: | 4443 Lyons Rd, Suite 211, Coconut Creek, FL 33073-4388 |
| Mail Address: | 4443 Lyons Rd, Suite 211, Coconut Creek, FL 33073-4388 |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1376014803 | 2018-12-10 | 2019-04-11 | 7611 MARBLEHEAD LN, PARKLAND, FL, 330672336, US | 4443 LYONS RD STE 211, COCONUT CREEK, FL, 330734388, US | |||||||||||||||||||||||||||
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| Phone | +1 301-802-7731 |
| Fax | 9543018501 |
Authorized person
| Name | MRS. CYNTHIA J RILLING |
| Role | COO |
| Phone | 3018027731 |
Taxonomy
| Taxonomy Code | 2083P0901X - Public Health & General Preventive Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1568426047 |
| State | IL |
| Issuer | MEDICAID |
| Number | 10231583092 |
| State | MD |
| Name | Role | Address |
|---|---|---|
| RILLING, KENT M | Agent | 7611 MARBLEHEAD LANE, PARKLAND, FL 33067 |
| Name | Role | Address |
|---|---|---|
| RILLING, KENT M | Authorized Member | 7611 MARBLEHEAD LANE, PARKLAND, FL 33067 |
| JANSON, KENNETH, Dr. | Authorized Member | 738 MARBLE WAY, BOCA RATON, FL 33432 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-04-13 | 4443 Lyons Rd, Suite 211, Coconut Creek, FL 33073-4388 | No data |
| CHANGE OF MAILING ADDRESS | 2020-04-13 | 4443 Lyons Rd, Suite 211, Coconut Creek, FL 33073-4388 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-01-21 | 7611 MARBLEHEAD LANE, PARKLAND, FL 33067 | No data |
| LC AMENDMENT AND NAME CHANGE | 2018-07-27 | PRECISION HEALTH BY SCIENCE, LLC | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-28 |
| ANNUAL REPORT | 2023-01-22 |
| ANNUAL REPORT | 2022-01-30 |
| ANNUAL REPORT | 2021-01-28 |
| ANNUAL REPORT | 2020-04-13 |
| ANNUAL REPORT | 2019-01-21 |
| LC Amendment and Name Change | 2018-07-27 |
| Florida Limited Liability | 2018-05-16 |
Date of last update: 18 Jan 2025
Sources: Florida Department of State
