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SOUTHERN PSYCHIATRY LLC - Florida Company Profile

Company Details

Entity Name: SOUTHERN PSYCHIATRY LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

SOUTHERN PSYCHIATRY LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act

Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 01 Feb 2019 (6 years ago)
Document Number: L19000028086
FEI/EIN Number 83-3067501

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 3906 US Highway 98, Santa Rosa Beach, FL, 32459, UN
Mail Address: 201 N BLUE HERON DR, SANTA ROSA BEACH, FL, 32459, UN
ZIP code: 32459
County: Walton
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1467917898 2019-02-11 2022-12-15 201 N BLUE HERON DR, SANTA ROSA BEACH, FL, 324593039, US 500 HOSPITAL DR, CRESTVIEW, FL, 325397355, US

Contacts

Phone +1 850-687-0887

Authorized person

Name RENEE MCCORMACK
Role OWNER
Phone 8506870887

Taxonomy

Taxonomy Code 363LF0000X - Family Nurse Practitioner
Is Primary No
Taxonomy Code 363LP0808X - Psychiatric/Mental Health Nurse Practitioner
Is Primary Yes
Taxonomy Code 363LP2300X - Primary Care Nurse Practitioner
Is Primary No

Key Officers & Management

Name Role Address
MCCORMACK JOSEPH IJR. Manager 201 N BLUE HERON DR, SANTA ROSA BEACH, FL, 32459
MCCORMACK RENEE R Agent 201 N BLUE HERON DR, SANTA ROSA BEACH, FL, 32459

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G19000072867 NOMADIC NURSE EXPIRED 2019-07-01 2024-12-31 - 3906 US 98 W #1522, SANTA ROSA BEACH, FL, 32459

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2021-03-19 3906 US Highway 98, #1522, Santa Rosa Beach, FL - FLORIDA 32459 UN -

Documents

Name Date
ANNUAL REPORT 2024-01-22
ANNUAL REPORT 2023-01-20
ANNUAL REPORT 2022-01-30
ANNUAL REPORT 2021-03-19
ANNUAL REPORT 2020-02-14
Florida Limited Liability 2019-02-01

Date of last update: 02 Apr 2025

Sources: Florida Department of State