| Entity Name: | KAIROS PROVIDER SOLUTIONS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 28 Oct 2021 (3 years ago) |
| Document Number: | L21000468637 |
| FEI/EIN Number | 87-3467081 |
| Address: | 27339 SORA BLVD, WESLEY CHAPEL, FL, 33544 |
| Mail Address: | PO BOX 561535, ROCKLEDGE, FL, 32256 |
| ZIP code: | 33544 |
| County: | Pasco |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1710642327 | 2021-11-08 | 2021-11-08 | PO BOX 561535, ROCKLEDGE, FL, 329561535, US | 27339 SORA BLVD, WESLEY CHAPEL, FL, 335443468, US | |||||||||||||
|
|||||||||||||||||
| Phone | +1 803-360-5359 |
Authorized person
| Name | DR. NGOZIKA BENYARD |
| Role | PHARMACIST |
| Phone | 8132397234 |
Taxonomy
| Taxonomy Code | 183500000X - Pharmacist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MITCHELL TRACI | Agent | 197 BOUGANVILLEA DRIVE, ROCKLEDGE, FL, 32955 |
| Name | Role |
|---|---|
| KAIROS MANAGEMENT GROUP, INC | Manager |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-04-28 |
| ANNUAL REPORT | 2022-04-20 |
| Florida Limited Liability | 2021-10-28 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
