| Entity Name: | BK PHYSICIAN SERVICES, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 16 Nov 2023 (a year ago) |
| Document Number: | L23000518964 |
| FEI/EIN Number | 93-4557082 |
| Address: | 10708 BRADBURY WAY, FORT MYERS, FL, 33913, US |
| Mail Address: | 10708 BRADBURY WAY, FORT MYERS, FL, 33913, US |
| ZIP code: | 33913 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1770353476 | 2024-01-03 | 2024-01-03 | 10708 BRADBURY WAY, FORT MYERS, FL, 339138417, US | 10708 BRADBURY WAY, FORT MYERS, FL, 339138417, US | |||||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 856-364-3067 |
Authorized person
| Name | BARRY K BUTLER |
| Role | OWNER |
| Phone | 8563643067 |
Taxonomy
| Taxonomy Code | 163W00000X - Registered Nurse |
| Is Primary | No |
| Taxonomy Code | 164W00000X - Licensed Practical Nurse |
| Is Primary | No |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 224Z00000X - Occupational Therapy Assistant |
| Is Primary | No |
| Taxonomy Code | 225100000X - Physical Therapist |
| Is Primary | No |
| Taxonomy Code | 225200000X - Physical Therapy Assistant |
| Is Primary | No |
| Taxonomy Code | 225X00000X - Occupational Therapist |
| Is Primary | No |
| Taxonomy Code | 235Z00000X - Speech-Language Pathologist |
| Is Primary | No |
| Taxonomy Code | 374U00000X - Home Health Aide |
| Is Primary | No |
| Name | Role |
|---|---|
| REGISTERED AGENTS INC | Agent |
| Name | Role | Address |
|---|---|---|
| BUTLER BARRY KENT | Authorized Member | 7901 4th St N, St. Petersburg, FL, 33702 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-19 |
| Florida Limited Liability | 2023-11-16 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
