| Entity Name: | EMERGENCY PHYSICIANS OF CROSSROADS LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 26 Apr 2023 (2 years ago) |
| Document Number: | L23000206867 |
| FEI/EIN Number | 92-3843139 |
| Address: | 701 6th St S, ST PETERSBURG, FL 33701 |
| Mail Address: | 701 6TH STREET SOUTH, ST PETERSBURG, FL 33710 |
| ZIP code: | 33701 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538858774 | 2023-05-03 | 2023-05-03 | 603 7TH ST S STE 360, ST PETERSBURG, FL, 337014732, US | 1800 66TH ST N, ST PETERSBURG, FL, 337108747, US | |||||||||||||||
|
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| Phone | +1 727-553-7300 |
| Phone | +1 727-823-1234 |
Authorized person
| Name | BRIAN HEDRICK |
| Role | PRESIDENT |
| Phone | 7275537300 |
Taxonomy
| Taxonomy Code | 207P00000X - Emergency Medicine Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| CHESTNUT BUSINESS SERVICES, LLC | Agent |
| Name | Role | Address |
|---|---|---|
| HEDRICK, BRIAN | Authorized Member | 603 7TH ST S. SUITE 360, ST PETERSBURG, FL 33701 |
| FREDERICKS, JENNIFER | Authorized Member | 603 7TH ST S. SUITE 360, ST PETERSBURG, FL 33701 |
| GILLIS, KRISTA | Authorized Member | 603 7TH ST S. SUITE 360, ST PETERSBURG, FL 33701 |
| HAWKINS, MARIBEL | Authorized Member | 603 7TH ST S. SUITE 360, ST PETERSBURG, FL 33701 |
| LAWLESS, MICHAEL | Authorized Member | 603 7TH ST S. SUITE 360, ST PETERSBURG, FL 33701 |
| MANZELLA, JASON, D.O. | Authorized Member | 603 7TH STREET SOUTH, SUITE 360 ST. PETERSBURG, FL 33701 |
| SHAMAS, ERIC, M.D. | Authorized Member | 603 7TH STREET SOUTH, SUITE 360 ST. PETERSBURG, FL 33701 |
| SALEH, ADEEB, D.O. | Authorized Member | 10941 ANCIENT FUTURES DRIVE, TAMPA, FL 33647 |
| SMITH, TAYLOR, M.D. | Authorized Member | 910 PINELLAS BAYWAY SOUTH, SUITE 360 APT. #205 TIERRA VERDE, FL 33715 |
| Name | Role | Address |
|---|---|---|
| GIRGIS, BETH | Managing Member | 603 7TH ST S. SUITE 360, ST PETERSBURG, FL 33701 |
| Name | Role | Address |
|---|---|---|
| RYAN, TRACI, D.O. | MEDICAL DIRECTOR | 201 SOUTH TRACK STREET, TAMPA, FL 33609 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-12-03 | 311 PARK PLACE BOULEVARD, SUITE 300, CLEARWATER, FL 33759 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-09-10 | 701 6th St S, ST PETERSBURG, FL 33701 | No data |
| CHANGE OF MAILING ADDRESS | 2024-01-25 | 701 6th St S, ST PETERSBURG, FL 33701 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-01-25 | CHESTNUT BUSINESS SERVICES, LLC | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-01-25 | 490 FIRST AVENUE SOUTH, SUITE 700, ST PETERSBURG, FL 33710 | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-01-26 |
| ANNUAL REPORT | 2024-01-25 |
| Florida Limited Liability | 2023-04-26 |
Date of last update: 10 Jan 2025
Sources: Florida Department of State
