| Entity Name: | SUNSHINE MEDICAL SPECIALISTS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 17 Sep 2019 (5 years ago) |
| Document Number: | L19000227602 |
| FEI/EIN Number | 84-3087268 |
| Address: | 6100 GREENLAND RD, JACKSONVILLE, FL, 32258, US |
| Mail Address: | 1334 N KYLE WAY, ST JOHNS, FL, 32259, US |
| ZIP code: | 32258 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336780907 | 2019-10-03 | 2020-04-01 | 1334 N KYLE WAY, SAINT JOHNS, FL, 322591927, US | 10175 FORTUNE PKWY, JACKSONVILLE, FL, 322566746, US | |||||||||||||||||||||
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| Phone | +1 904-533-6868 |
| Fax | 9047704003 |
Authorized person
| Name | THANH NGUYEN |
| Role | OWNER |
| Phone | 9045336868 |
Taxonomy
| Taxonomy Code | 2080P0205X - Pediatric Endocrinology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 103328600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| NGUYEN THANH M | Agent | 1334 N KYLE WAY, ST JOHNS, FL, 32259 |
| Name | Role | Address |
|---|---|---|
| NGUYEN THANH M | Manager | 1334 N KYLE WAY, ST JOHNS, FL, 32259 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-01-28 | 6100 GREENLAND RD, STE 604, JACKSONVILLE, FL 32258 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-01-28 | 1334 N KYLE WAY, ST JOHNS, FL 32259 | No data |
| REGISTERED AGENT NAME CHANGED | 2020-03-07 | NGUYEN, THANH MINH | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-16 |
| ANNUAL REPORT | 2023-03-04 |
| ANNUAL REPORT | 2022-01-23 |
| ANNUAL REPORT | 2021-01-28 |
| ANNUAL REPORT | 2020-03-07 |
| Florida Limited Liability | 2019-09-17 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
