| Entity Name: | K A COMPREHENSIVE MEDICAL AND PSYCHIATRIC SERVICES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 11 Dec 2019 (5 years ago) |
| Date of dissolution: | 13 Jun 2024 (8 months ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 13 Jun 2024 (8 months ago) |
| Document Number: | L19000301541 |
| FEI/EIN Number | 84-3889338 |
| Address: | 6801 Lake Worth Road,, SUITE 219, Green Acres, FL 33467 |
| Mail Address: | 6801 Lake Worth Road,, SUITE 219, Green Acres, FL 33467 |
| ZIP code: | 33467 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1558991646 | 2020-01-17 | 2022-08-02 | 6801 LAKE WORTH RD STE 219, GREENACRES, FL, 334672966, US | 6801 LAKE WORTH RD STE 219, GREENACRES, FL, 334672966, US | |||||||||||||||||||||
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| Phone | +1 561-328-8420 |
| Fax | 5618282884 |
Authorized person
| Name | ACELISE ALEXIS |
| Role | CEO |
| Phone | 5614104180 |
Taxonomy
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHEILD, SUNSHINE, MEDICARE, UHC, AETNA, CIGNA |
| Number | APRN9203914 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| K A COMPREHENSIVE MEDICAL AND PSYCHIATRIC | Agent | 6801 Lake Worth Road,, SUITE 219, Green Acres, FL 33467 |
| Name | Role | Address |
|---|---|---|
| ALEXIS, ACELISE | Manager | 6801 Lake Worth Road,, SUITE 219 Green Acres, FL 33467 |
| Alexis, Jean Jude | Manager | 6801 Lake Worth Road,, SUITE 219 Green Acres, FL 33467 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2024-06-13 | No data | No data |
| LC REVOCATION OF DISSOLUTION | 2024-02-27 | No data | No data |
| VOLUNTARY DISSOLUTION | 2023-12-21 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-06-13 | 6801 Lake Worth Road,, SUITE 219, Green Acres, FL 33467 | No data |
| REINSTATEMENT | 2022-10-24 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2022-08-03 | 6801 Lake Worth Road,, SUITE 219, Green Acres, FL 33467 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-08-03 | 6801 Lake Worth Road,, SUITE 219, Green Acres, FL 33467 | No data |
| REINSTATEMENT | 2021-11-23 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2024-06-13 |
| LC Revocation of Dissolution | 2024-02-27 |
| VOLUNTARY DISSOLUTION | 2023-12-21 |
| AMENDED ANNUAL REPORT | 2023-06-13 |
| ANNUAL REPORT | 2023-03-27 |
| REINSTATEMENT | 2022-10-24 |
| REINSTATEMENT | 2021-11-23 |
| REINSTATEMENT | 2020-11-06 |
| Florida Limited Liability | 2019-12-11 |
Date of last update: 15 Feb 2025
Sources: Florida Department of State
