| Entity Name: | SPECIALIZED CARE INITIATIVE, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 12 Jun 2024 (8 months ago) |
| Document Number: | L24000264231 |
| Address: | 8348 LITTLE ROAD, SUITE 149, NEW PORT RICHEY, FL, 34654, US |
| Mail Address: | 8348 LITTLE ROAD, SUITE 149, NEW PORT RICHEY, FL, 34654, US |
| ZIP code: | 34654 |
| County: | Pasco |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1255179743 | 2024-07-18 | 2024-07-18 | 8348 LITTLE ROAD, STE 149, NEW PORT RICHEY, FL, 346544919, US | 8348 LITTLE RD STE 149, NEW PORT RICHEY, FL, 346544919, US | |||||||||||||||||
|
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| Phone | +1 855-232-0644 |
Authorized person
| Name | JEFFREY WACKSMAN |
| Role | AUTHORIZED OFFICIAL |
| Phone | 8552320644 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 363LA2200X - Adult Health Nurse Practitioner |
| Is Primary | Yes |
| Name | Role |
|---|---|
| CHESTNUT BUSINESS SERVICES, LLC | Agent |
| Name | Role | Address |
|---|---|---|
| MORRISON CHRISTOPHER M.D. | Manager | 8348 LITTLE ROAD, SUITE 149, NEW PORT RICHEY, FL, 34654 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-12-03 | 311 PARK PLACE BOULEVARD, SUITE 300, CLEARWATER, FL 33759 | No data |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-06-12 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
