| Entity Name: | NATIONAL HEALTH SCREEN LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 09 Aug 2023 (2 years ago) |
| Document Number: | L23000376295 |
| FEI/EIN Number | 93-2858324 |
| Address: | 12425 28th Street n, Ste 304, St Petersburg, FL 33716 |
| Mail Address: | 12425 28th Street n, Ste 304, St Petersburg, FL 33716 |
| ZIP code: | 33716 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| Type | Company Name | Company Number | State |
|---|---|---|---|
| Headquarter of | NATIONAL HEALTH SCREEN LLC, KENTUCKY | 1318339 | KENTUCKY |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982852992 | 2008-09-03 | 2024-04-26 | 12425 28TH STREET N, STE 304, ST PETERSBURG, FL, 33716, US | 12425 28TH STREET N, STE 101, ST PETERSBURG, FL, 33716, US | |||||||||||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 727-669-4551 |
| Fax | 7276692420 |
Authorized person
| Name | MRS. CASSANDRA LEIGH ABDISHI |
| Role | CHIEF OPERATING OFFICER |
| Phone | 7276694551 |
Taxonomy
| Taxonomy Code | 251K00000X - Public Health or Welfare Agency |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | No |
| Taxonomy Code | 261QC1800X - Corporate Health Clinic/Center |
| Is Primary | Yes |
| Taxonomy Code | 261QH0100X - Health Service Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 291U00000X - Clinical Medical Laboratory |
| License Number | 800018825 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 305S00000X - Point of Service |
| Is Primary | No |
Other Provider Identifiers
| Issuer | HEALTHCARE CLINIC ESTABLISHMENT |
| Number | 800018825 |
| State | FL |
| Issuer | CMS CLIA CERTIFICATE OF WAIVER |
| Number | 10D1020546 |
| State | FL |
| Name | Role |
|---|---|
| BUSINESS FILINGS INCORPORATED | Agent |
| Name | Role | Address |
|---|---|---|
| GATT, ROCHELLE | Vice President | 7673 N Pinesview Dr, Scottsdale, AZ 85258 |
| Name | Role | Address |
|---|---|---|
| GATT, STEVEN | President | 7673 N Pinesview Drive, Scottsdale, AZ 85258 |
| Name | Role | Address |
|---|---|---|
| Abdishi, Cassandra | Chief Operating Officer | 1700 N MCMULLEN BOOTH RD, STE C3, CLEARWATER, FL 33759 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000126523 | HEALTH & WELLNESS PROFESSIONALS | ACTIVE | 2023-10-12 | 2028-12-31 | No data | 12425 28TH ST N, STE 304, ST PETERSBURG, FL, 33716 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-02-08 | 12425 28th Street n, Ste 304, St Petersburg, FL 33716 | No data |
| CHANGE OF MAILING ADDRESS | 2024-02-08 | 12425 28th Street n, Ste 304, St Petersburg, FL 33716 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-15 |
| ANNUAL REPORT | 2024-01-03 |
| Florida Limited Liability | 2023-08-09 |
Date of last update: 09 Feb 2025
Sources: Florida Department of State
