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HEALTHSTAT PENSACOLA, LLC - Florida Company Profile

Company Details

Entity Name: HEALTHSTAT PENSACOLA, LLC
Jurisdiction: FLORIDA
Filing Type: Foreign Limited Liability Co.
Status: Inactive

The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders.

Date Filed: 06 Jun 2011 (14 years ago)
Date of dissolution: 09 Jun 2023 (2 years ago)
Last Event: LC WITHDRAWAL
Event Date Filed: 09 Jun 2023 (2 years ago)
Document Number: M11000002875
FEI/EIN Number 45-2451706

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 4651 Charlotte Park Drive, Charlotte, NC, 28217, US
Mail Address: 4651 Charlotte Park Drive, Charlotte, NC, 28217, US
Place of Formation: NORTH CAROLINA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1053606988 2011-06-20 2011-10-04 4601 CHARLOTTE PARK DR, SUITE 390, CHARLOTTE, NC, 282171915, US 1678 AIRPORT BLVD, PENSACOLA, FL, 325048618, US

Contacts

Phone +1 704-529-6161
Fax 7049365570
Phone +1 850-479-3790
Fax 8504793920

Authorized person

Name SUSAN KINZLER
Role EVP SALES & MARKETING
Phone 7045296161

Taxonomy

Taxonomy Code 207Q00000X - Family Medicine Physician
Is Primary Yes

Other Provider Identifiers

Issuer NCPDP PROVIDER IDENTIFICATION NUMBER
Number 5706657

Key Officers & Management

Name Role Address
MILLER CHRIS President 1400 Wewatta Street, Denver, CO, 80202
DIXON HEATHER Treasurer 400 Wewatta Street, Denver, CO, 80202
TSUDA MICHI Secretary 1400 Wewatta Street, Denver, CO, 80202

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G12000007244 HEALTHSTAT EXPIRED 2012-01-20 2017-12-31 - 4601 CHARLOTTE PARK DRIVE, SUITE 390, CHARLOTTE, NC, 28217

Events

Event Type Filed Date Value Description
REGISTERED AGENT CHANGED 2023-06-09 REGISTERED AGENT REVOKED -
WITHDRAWAL 2023-06-09 - -
LC WITHDRAWAL 2023-06-09 - -
REINSTATEMENT 2023-06-09 - -
REVOKED FOR ANNUAL REPORT 2022-09-23 - -
CHANGE OF MAILING ADDRESS 2018-04-23 4651 Charlotte Park Drive, Suite 300, Charlotte, NC 28217 -
CHANGE OF PRINCIPAL ADDRESS 2018-04-23 4651 Charlotte Park Drive, Suite 300, Charlotte, NC 28217 -
REINSTATEMENT 2013-07-29 - -
REVOKED FOR ANNUAL REPORT 2012-09-28 - -

Documents

Name Date
REINSTATEMENT 2023-06-09
WITHDRAWAL 2023-06-09
ANNUAL REPORT 2021-04-27
ANNUAL REPORT 2020-04-13
ANNUAL REPORT 2019-04-17
ANNUAL REPORT 2018-04-23
ANNUAL REPORT 2017-04-14
ANNUAL REPORT 2016-04-26
ANNUAL REPORT 2015-04-29
ANNUAL REPORT 2014-05-01

Date of last update: 02 Mar 2025

Sources: Florida Department of State