| Entity Name: | PATRIOT ONCOLOGY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 24 May 2019 (6 years ago) |
| Document Number: | L19000139913 |
| FEI/EIN Number | 84-1874632 |
| Address: | 100 ARRICOLA AVE, ST AUGUSTINE, FL 32080 |
| Mail Address: | 100 ARRICOLA AVE, ST AUGUSTINE, FL 32080 |
| ZIP code: | 32080 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1770142523 | 2019-06-06 | 2020-04-27 | 100 ARRICOLA AVE, ST AUGUSTINE, FL, 320804515, US | 100 ARRICOLA AVE, ST AUGUSTINE, FL, 320804515, US | |||||||||||||||||||
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| Phone | +1 904-825-4368 |
Authorized person
| Name | ROY H HINMAN |
| Role | CEO/CMO |
| Phone | 9048254368 |
Taxonomy
| Taxonomy Code | 261QX0200X - Oncology Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE |
| Number | 09732A |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HINMAN, ROY H, II | Agent | 100 ARRICOLA AVE, ST AUGUSTINE, FL 32080 |
| Name | Role | Address |
|---|---|---|
| HINMAN, ROY H, II | Manager | 100 ARRICOLA AVE, ST AUGUSTINE, FL 32080 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-03-09 |
| ANNUAL REPORT | 2022-01-21 |
| ANNUAL REPORT | 2021-03-23 |
| ANNUAL REPORT | 2020-03-16 |
| Florida Limited Liability | 2019-05-24 |
Date of last update: 16 Feb 2025
Sources: Florida Department of State
