| Entity Name: | BRISTOL PALLIATIVE CARE SERVICES - FLORIDA, L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 24 Aug 2021 (4 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 16 Apr 2024 (10 months ago) |
| Document Number: | L21000385123 |
| FEI/EIN Number | 87-2645454 |
| Address: | 5201 BLUE LAGOON DR SUITE 570, MIAMI, FL 33126 |
| Mail Address: | 2002 Timberloch Place, Suite 150A, THE WOODLANDS, TX 77380 |
| ZIP code: | 33126 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1932879103 | 2021-09-17 | 2022-02-28 | 5201 BLUE LAGOON DR STE 570, MIAMI, FL, 331262075, US | 5201 BLUE LAGOON DR STE 570, MIAMI, FL, 331262075, US | |||||||||||||||
|
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| Phone | +1 786-382-0433 |
| Fax | 7862542556 |
Authorized person
| Name | DR. JOSE E BARROS |
| Role | MEMBER |
| Phone | 7623820433 |
Taxonomy
| Taxonomy Code | 207RH0002X - Hospice and Palliative Medicine (Internal Medicine) Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| BRISTOL HOSPICE - MIAMI DADE, LLC | Agent |
| Name | Role | Address |
|---|---|---|
| BARROS, JOSE, DR. | Authorized Member | 5201 BLUE LAGOON DR SUITE 570, MIAMI, FL 33126 |
| Name | Role | Address |
|---|---|---|
| Broadway, Melissa | Chief Quality Officer | 2002 Timberloch Place, Suite 150A THE WOODLANDS, TX 77380 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000165693 | BRISTOL ADVANCE ILLNESS MANAGEMENT | ACTIVE | 2021-12-15 | 2026-12-31 | No data | 5201 BLUE LAGOON DR SUITE 570, MIAMI, FL, 33126 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2024-04-16 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-16 | 5201 BLUE LAGOON DR SUITE 570, MIAMI, FL 33126 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2022-12-21 | Bristol Hospice - Miami Dade, LLC | No data |
| REINSTATEMENT | 2022-12-21 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-12-14 | 155 OFFICE PLAZA DR., SUITE A, TALLAHASSEE, FL 32301 | No data |
| LC STMNT OF RA/RO CHG | 2021-12-14 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-02-06 |
| REINSTATEMENT | 2024-04-16 |
| REINSTATEMENT | 2022-12-21 |
| CORLCRACHG | 2021-12-14 |
| Florida Limited Liability | 2021-08-24 |
Date of last update: 13 Feb 2025
Sources: Florida Department of State
