| Entity Name: | P31 LIFE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 19 Jan 2021 (4 years ago) |
| Document Number: | L21000036999 |
| FEI/EIN Number | 86-1934939 |
| Address: | 1992 Lewis Turner Blvd, Suite 2107, FORT WALTON BEACH, FL 32547 |
| Mail Address: | 1992 Lewis Turner Blvd, SUITE 186, Suite 2107, FORT WALTON BEACH, FL 32547 |
| ZIP code: | 32547 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336819788 | 2021-09-16 | 2021-09-23 | 7901 4TH ST N STE 300, SAINT PETERSBURG, FL, 337024399, US | 7901 4TH ST N STE 300, SAINT PETERSBURG, FL, 337024399, US | |||||||||||||||||
|
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| Phone | +1 305-924-5397 |
Authorized person
| Name | DIANNE SMITH |
| Role | OWNER |
| Phone | 8634557300 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | No |
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Smith , Dianne | Agent | 1992 Lewis Turner Blvd, STE 300, Suite 2107, FORT WALTON BEACH, FL 32547 |
| Name | Role | Address |
|---|---|---|
| Smith, Dianne | Authorized Member | 1992 Lewis Turner Blvd, Suite 2107 FORT WALTON BEACH, FL 32547 |
| Name | Role | Address |
|---|---|---|
| SMITH , DANNY | MANAGING MEMBER | 1992 Lewis Turner Blvd, Suite 2107 FORT WALTON BEACH, FL 32547 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000137798 | INSPIRE PSYCHIATRY ASSOCIATES | ACTIVE | 2022-11-04 | 2027-12-31 | No data | 1317 EDGEWATER DR, #697, ORLANDO, FL, 32804 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-25 | 1992 Lewis Turner Blvd, Suite 2107, FORT WALTON BEACH, FL 32547 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-25 | 1992 Lewis Turner Blvd, Suite 2107, FORT WALTON BEACH, FL 32547 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-04-25 | Smith , Dianne | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-25 | 1992 Lewis Turner Blvd, STE 300, Suite 2107, FORT WALTON BEACH, FL 32547 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-25 |
| ANNUAL REPORT | 2023-04-30 |
| ANNUAL REPORT | 2022-04-19 |
| Florida Limited Liability | 2021-01-19 |
Date of last update: 15 Jan 2025
Sources: Florida Department of State
