| Entity Name: | ST. PETE HEALTH ASSOCIATES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 16 Jul 2019 (6 years ago) |
| Document Number: | L19000183243 |
| FEI/EIN Number | 84-2683451 |
| Address: | 2201 58TH ST N, SAINT PETERSBURG, FL, 33710, US |
| Mail Address: | 215 Medallion Blvd Unit F, Madeira Beach, FL, 33708, US |
| ZIP code: | 33710 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538498985 | 2009-12-14 | 2020-01-03 | 2201 58TH ST N, ST. PETERSBURG, FL, 337104236, US | 2201 58TH ST N, ST. PETERSBURG, FL, 337104236, US | |||||||||||||||||||||||||||||||
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| Phone | +1 727-202-7250 |
| Fax | 7272077256 |
Authorized person
| Name | JAMES M BENZSCHAWEL |
| Role | OWNER |
| Phone | 7272027250 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | 4030-12 |
| State | WI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 104249200 |
| State | FL |
| Issuer | MEDICAID |
| Number | 38955100 |
| State | WI |
| Name | Role | Address |
|---|---|---|
| BENZSCHAWEL JAMES MDR. | Agent | 2201 58TH ST. N, SAINT PETERSBURG, FL, 33710 |
| Name | Role | Address |
|---|---|---|
| BENZSCHAWEL JAMES MDR. | President | 215 Medallion Blvd Unit F, Madeira Beach, FL, 33708 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2020-06-08 | 2201 58TH ST N, SAINT PETERSBURG, FL 33710 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-02 |
| ANNUAL REPORT | 2024-01-31 |
| ANNUAL REPORT | 2023-02-04 |
| ANNUAL REPORT | 2022-03-02 |
| ANNUAL REPORT | 2021-07-27 |
| ANNUAL REPORT | 2020-06-08 |
| Florida Limited Liability | 2019-07-16 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
