| Entity Name: | TOLES PROVIDER SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 22 Jun 2020 (5 years ago) |
| Date of dissolution: | 23 Sep 2022 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (2 years ago) |
| Document Number: | L20000172692 |
| FEI/EIN Number | 85-1578057 |
| Address: | 5319 19TH AVE SW, NAPLES, FL 34116 |
| Mail Address: | 5319 19TH AVE SW, NAPLES, FL 34116 |
| ZIP code: | 34116 |
| County: | Collier |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1184385874 | 2022-01-04 | 2022-03-15 | 5319 19TH AVE SW, NAPLES, FL, 341165631, US | 5319 19TH AVE SW, NAPLES, FL, 341165631, US | |||||||||||||||||||||||||||
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| Phone | +1 239-595-9040 |
| Fax | 2393307028 |
Authorized person
| Name | JERJUAN TOLES |
| Role | OWNER |
| Phone | 2395959040 |
Taxonomy
| Taxonomy Code | 171M00000X - Case Manager/Care Coordinator |
| Is Primary | No |
| Taxonomy Code | 171W00000X - Contractor |
| Is Primary | No |
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | Yes |
| Taxonomy Code | 343900000X - Non-emergency Medical Transport (VAN) |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| TOLES, JERJUAN D | Agent | 5319 19TH AVE SW, NAPLES, FL 34116 |
| Name | Role | Address |
|---|---|---|
| TOLES, JERJUAN D | Chief Executive Officer | 5319 19TH AVE SW, NAPLES, FL 34116 |
| Name | Role | Address |
|---|---|---|
| TOLES, EUNICE J | Manager | 5319 19TH AVE SW, NAPLES, FL 34116 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2021-03-13 | 5319 19TH AVE SW, NAPLES, FL 34116 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-03-13 | 5319 19TH AVE SW, NAPLES, FL 34116 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-01-18 | 5319 19TH AVE SW, NAPLES, FL 34116 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2021-03-13 |
| Florida Limited Liability | 2020-06-22 |
Date of last update: 15 Feb 2025
Sources: Florida Department of State
