| Entity Name: | PREMIER DIALYSIS SERVICE SEBASTIAN LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 30 Sep 2021 (3 years ago) |
| Document Number: | L21000429862 |
| FEI/EIN Number | 87-3874225 |
| Mail Address: | 13044 MONINGTON CT, FENTON, MI, 48430, US |
| Address: | 4325 Sun N Lake Blvd, Suite 103, Sebring, FL, 33872, US |
| ZIP code: | 33872 |
| County: | Highlands |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538820030 | 2022-01-06 | 2022-10-10 | 13044 MONINGTON CT, FENTON, MI, 484301191, US | 4325 SUN N LAKE BLVD, SEBRING, FL, 338722171, US | |||||||||||||
|
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| Phone | +1 888-549-6990 |
Authorized person
| Name | JOSHUA DIPZINSKI |
| Role | OWNER |
| Phone | 8885436390 |
Taxonomy
| Taxonomy Code | 261QE0700X - End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DIPZINSKI JOSHUA D | Agent | 4325 Sun N Lake Blvd, Sebring, FL, 33872 |
| Name | Role | Address |
|---|---|---|
| PREMIER DIALYSIS SERVICE LLC | Manager | 13044 MONINGTON CT, FENTON, MI, 48430 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000004344 | HTTPS://AHCA.MYFLORIDA.COM/MCHQ/HEALTH_FACILITY_REGULATION/LAB_HOMESERV/ESRD.SHTML | ACTIVE | 2022-01-11 | 2027-12-31 | No data | 13044 MONINGTON CT, FENTON, MI, 48430 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-03-07 | 4325 Sun N Lake Blvd, Suite 103, Sebring, FL 33872 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-03-07 | 4325 Sun N Lake Blvd, Suite 103, Sebring, FL 33872 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-06 |
| ANNUAL REPORT | 2023-01-25 |
| ANNUAL REPORT | 2022-03-07 |
| Florida Limited Liability | 2021-09-30 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
