| Entity Name: | BRUNETTE BASTIEN MEDICAL SERVICES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 02 May 2022 (3 years ago) |
| Date of dissolution: | 27 Dec 2023 (a year ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 27 Dec 2023 (a year ago) |
| Document Number: | L22000205579 |
| FEI/EIN Number | 88-3263893 |
| Address: | 1425 VISCAYA PARKWAY, 101, CAPLE CORAL, FL 33991 |
| Mail Address: | 343 10TH ST SE, NAPLES, FL 34117 |
| ZIP code: | 33991 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114652476 | 2022-07-20 | 2023-02-01 | 1425 VISCAYA PKWY STE 101, CAPE CORAL, FL, 339903294, US | 1425 VISCAYA PKWY STE 101, CAPE CORAL, FL, 339903294, US | |||||||||||||||||||||
|
|||||||||||||||||||||||||
| Phone | +1 239-919-4851 |
| Fax | 2392361200 |
| Phone | +1 239-293-5829 |
Authorized person
| Name | MS. BRUNETTE BASTIEN |
| Role | OWNER |
| Phone | 2399194851 |
Taxonomy
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | Yes |
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| BASTIEN, BRUNETTE | Agent | 2041 Jalen Street, Hollister, FL 95023 |
| Name | Role | Address |
|---|---|---|
| BASTIEN, BRUNETTE | Manager | 2041 Jalen Street, Hollister, FL 95023 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2025-10-01 | 1425 VISCAYA PARKWAY, 101, CAPLE CORAL, FL 33991 | No data |
| CHANGE OF MAILING ADDRESS | 2024-10-01 | 1425 VISCAYA PARKWAY, 101, CAPLE CORAL, FL 33991 | No data |
| VOLUNTARY DISSOLUTION | 2023-12-27 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-03-29 | 2041 Jalen Street, Hollister, FL 95023 | No data |
| LC AMENDMENT AND NAME CHANGE | 2022-05-09 | BRUNETTE BASTIEN MEDICAL SERVICES LLC | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2023-12-27 |
| ANNUAL REPORT | 2023-03-29 |
| LC Amendment and Name Change | 2022-05-09 |
| Florida Limited Liability | 2022-05-02 |
Date of last update: 12 Feb 2025
Sources: Florida Department of State
