| Entity Name: | SOUTHERN PHYSICIANS GROUP, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 08 Mar 2022 (3 years ago) |
| Document Number: | L22000118823 |
| FEI/EIN Number | 88-1093374 |
| Address: | 7045 75TH STREET NORTH, PINELLAS PARK, FL, 33781, US |
| Mail Address: | 7045 75TH STREET NORTH, PINELLAS PARK, FL, 33781, US |
| ZIP code: | 33781 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245098185 | 2024-03-06 | 2024-03-18 | 7045 75TH ST N, PINELLAS PARK, FL, 337813748, US | 1609 PASADENA AVE S STE 1E, SOUTH PASADENA, FL, 337074555, US | |||||||||||||||||||
|
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| Phone | +1 919-349-1232 |
| Fax | 7276779333 |
Authorized person
| Name | BRYAN FINK |
| Role | PRESIDENT |
| Phone | 7276779333 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 2083P0011X - Undersea and Hyperbaric Medicine (Preventive Medicine) Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| FINK BRYAN P | Agent | 7045 75TH STREET NORTH, PINELLAS PARK, FL, 33781 |
| Name | Role | Address |
|---|---|---|
| FINK BRYAN P | Authorized Member | 7045 75TH STREET NORTH, PINELLAS PARK, FL, 33781 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-11 |
| ANNUAL REPORT | 2023-02-02 |
| Florida Limited Liability | 2022-03-08 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
