| Entity Name: | KIM HOLLINGSWORTH, APRN, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 30 Jun 2022 (3 years ago) |
| Document Number: | L22000295841 |
| FEI/EIN Number | 883021257 |
| Address: | 4805 North Dixie Highway Suite B, FT LAUDERDALE, FL, 33334, US |
| Mail Address: | 5151 COLLINS AVE., #1120, MIAMI BEACH, FL, 33140, US |
| ZIP code: | 33334 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013649821 | 2022-06-29 | 2022-11-16 | 3801 N UNIVERSITY DR STE 501, SUNRISE, FL, 333516320, US | 4805 N DIXIE HWY STE B, OAKLAND PARK, FL, 333343928, US | |||||||||||||
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| Phone | +1 786-877-4922 |
Authorized person
| Name | KIMBERLY HOLLINGSWORTH |
| Role | SOLE PROPRIETOR |
| Phone | 7868774922 |
Taxonomy
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| ST. JOHN SUSAN ESQ. | Agent | c/o Garfunkel Wild, PC, Fort Lauderdale, FL, 33301 |
| Name | Role | Address |
|---|---|---|
| HOLLINGSWORTH KIM APRN | Authorized Member | 5151 COLLINS AVENUE, #1120, MIAMI BEACH, FL, 33140 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-17 | 4805 North Dixie Highway Suite B, FT LAUDERDALE, FL 33334 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-17 | c/o Garfunkel Wild, PC, 401 E. Las Olas Blvd., Suite 1423, Fort Lauderdale, FL 33301 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-23 |
| ANNUAL REPORT | 2023-04-17 |
| Florida Limited Liability | 2022-06-30 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
