| Entity Name: | THRIVE FAMILY PRACTICE PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 23 Jun 2021 (4 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 03 Nov 2022 (2 years ago) |
| Document Number: | L21000290402 |
| FEI/EIN Number | 87-1369747 |
| Address: | 14851 State Road 52, Hudson, FL, 34669, US |
| Mail Address: | 14851 State Road 52, Hudson, FL, 34669, US |
| ZIP code: | 34669 |
| County: | Pasco |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1306519962 | 2021-07-29 | 2022-03-18 | 10724 BURNING BUSH TER, LAND O LAKES, FL, 346386883, US | 19455 SHUMARD OAK DR UNIT 105, LAND O LAKES, FL, 346387257, US | |||||||||||||||||||||||||||
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| Phone | +1 813-751-5074 |
Authorized person
| Name | PATRICIA TRNKA-STONE |
| Role | OWNER |
| Phone | 8137515074 |
Taxonomy
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | Yes |
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | No |
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 111347200 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| THRIVE FAMILY PRACTICE 401(K) PLAN | 2023 | 871369747 | 2024-09-13 | THRIVE FAMILY PRACTICE PLLC | 7 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-09-13 |
| Name of individual signing | SHIRLEY HORNER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-03-01 |
| Business code | 621498 |
| Sponsor’s telephone number | 8137515074 |
| Plan sponsor’s address | 10724 BURNING BUSH TER, LAND O LAKES, FL, 34638 |
Signature of
| Role | Plan administrator |
| Date | 2023-09-13 |
| Name of individual signing | SHIRLEY HORNER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role |
|---|---|
| UNITED STATES CORPORATION AGENTS, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| TRNKA-STONE PATRICIA M | Authorized Member | 10724 BURNING BUSH TER., LAND O LAKES, FL, 34638 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-09 | 14851 State Road 52, Unit 107 #128, Hudson, FL 34669 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-09 | 14851 State Road 52, Unit 107 #128, Hudson, FL 34669 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-04-09 | United States Corporation Agents, Inc. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-09 | 476 Riverside Ave., Jacksonville, FL 32202 | No data |
| REINSTATEMENT | 2022-11-03 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| LC AMENDMENT | 2021-07-16 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J24000691202 | ACTIVE | 2024CC003866CCAXES | PASCO COUNTY COUNTY COURT | 2024-10-24 | 2029-11-05 | $24,469.50 | PAWNEE LEASING CORPORATION, 3801 AUTOMATION WAY, SUITE 207, FORT COLLINS, CO 80525 |
| J24000183234 | ACTIVE | 2022-CA-002956 | PASCO CTY CT 6TH JUD CIR | 2023-11-16 | 2029-04-02 | $20,509.00 | IMS FUND, LLC, 247 W 36TH STREET, NEW YORK, NY 10018 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-09 |
| ANNUAL REPORT | 2023-03-16 |
| REINSTATEMENT | 2022-11-03 |
| LC Amendment | 2021-07-16 |
| Florida Limited Liability | 2021-06-23 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
