| Entity Name: | FAS FLORIDA PATIENT SERVICES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 07 Nov 2024 (3 months ago) |
| Document Number: | L24000473204 |
| Address: | 8500 EAGLE RUN DR, BOCA RATON, FL 33434 |
| Mail Address: | 8500 EAGLE RUN DR, BOCA RATON, FL 33434 |
| ZIP code: | 33434 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073336988 | 2024-11-07 | 2024-11-07 | 8500 EAGLE RUN DR, BOCA RATON, FL, 334345430, US | 8500 EAGLE RUN DR, BOCA RATON, FL, 334345430, US | |||||||||||||||
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| Phone | +1 561-806-0600 |
| Fax | 5615010099 |
Authorized person
| Name | DANIEL SELBST |
| Role | MGR |
| Phone | 5618060600 |
Taxonomy
| Taxonomy Code | 207XX0004X - Orthopaedic Foot and Ankle Surgery Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SELBST, DANIEL | Agent | 8500 EAGLE RUN DR, BOCA RATON, FL 33434 |
| Name | Role | Address |
|---|---|---|
| SELBST, DANIEL | Manager | 8500 EAGLE RUN DR, BOCA RATON, FL 33434 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-11-07 |
Date of last update: 07 Feb 2025
Sources: Florida Department of State
