| Entity Name: | RESPIRE PULMONARY AND SLEEP MEDICINE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 14 Jul 2020 (5 years ago) |
| Document Number: | L20000204194 |
| FEI/EIN Number | 85-2128071 |
| Address: | 2484 n essex ave, hernando, FL 34442 |
| Mail Address: | 2484 n essex ave, hernando, FL 34442 |
| ZIP code: | 34442 |
| County: | Citrus |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1588265458 | 2020-11-05 | 2023-01-24 | 2484 N ESSEX AVE, HERNANDO, FL, 344425321, US | 2484 N ESSEX AVE, HERNANDO, FL, 344425321, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 352-249-5338 |
| Fax | 3522803066 |
Authorized person
| Name | DR. LEE R GONZALEZ |
| Role | PRESIDENT |
| Phone | 6034389090 |
Taxonomy
| Taxonomy Code | 207RC0200X - Critical Care Medicine (Internal Medicine) Physician |
| Is Primary | No |
| Taxonomy Code | 207RP1001X - Pulmonary Disease Physician |
| Is Primary | Yes |
| Taxonomy Code | 207RS0012X - Sleep Medicine (Internal Medicine) Physician |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 108677900 |
| State | FL |
| Issuer | FLORIDA BLUE |
| Number | QFM67 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GONZALEZ, LEE | Agent | 547 NW 9th Ave, Crystal River, FL 34428 |
| Name | Role |
|---|---|
| RESPIRE HEALTH CORP | Authorized Member |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000135879 | PULMONARY AND SLEEP INSTITUTE OF CITRUS HILLS | ACTIVE | 2020-10-20 | 2025-12-31 | No data | 2484 N ESSEX AVE, HERNANDO, FL, 34442 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2021-03-10 | 547 NW 9th Ave, Crystal River, FL 34428 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-01-05 | 2484 n essex ave, hernando, FL 34442 | No data |
| CHANGE OF MAILING ADDRESS | 2021-01-05 | 2484 n essex ave, hernando, FL 34442 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-04-25 |
| ANNUAL REPORT | 2022-04-25 |
| ANNUAL REPORT | 2021-03-10 |
| Florida Limited Liability | 2020-07-14 |
Date of last update: 15 Jan 2025
Sources: Florida Department of State
