| Entity Name: | SHERIDAN EMERGENCY PHYSICIAN SERVICES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 15 Nov 2000 (24 years ago) |
| Document Number: | P00000106942 |
| FEI/EIN Number | 651057394 |
| Address: | 20 Burton Hills Blvd, Suite 500, Nashville, TN, 37215, US |
| Mail Address: | 20 Burton Hills Blvd, Suite 500, Nashville, TN, 37215, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1659045862 | 2021-08-03 | 2021-08-03 | 5565 CENTERVIEW DR STE 107, RALEIGH, NC, 276063563, US | 1210 S OLD DIXIE HWY, JUPITER, FL, 334587205, US | |||||||||||||||||||||
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| Phone | +1 973-251-1132 |
Authorized person
| Name | KATHY KONDAS |
| Role | OFFICER |
| Phone | 9732511132 |
Taxonomy
| Taxonomy Code | 207P00000X - Emergency Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 363A00000X - Physician Assistant |
| Is Primary | No |
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | No |
| CIK number | Mailing Address | Business Address | Phone | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1624708 | 20 BURTON HILLS BLVD., 5TH FLOOR, NASHVILLE, TN, 37215 | 20 BURTON HILLS BLVD., 5TH FLOOR, NASHVILLE, TN, 37215 | 615-665-1283 | |||||||||||||||||||||||||||||||||
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| Form type | 15-15D |
| File number | 333-201255-10 |
| Filing date | 2016-12-13 |
| File | View File |
Filings since 2015-01-16
| Form type | 424B3 |
| File number | 333-201255-10 |
| Filing date | 2015-01-16 |
| File | View File |
Filings since 2015-01-12
| Form type | EFFECT |
| File number | 333-201255-10 |
| Filing date | 2015-01-12 |
| File | View File |
Filings since 2014-12-24
| Form type | S-4 |
| File number | 333-201255-10 |
| Filing date | 2014-12-24 |
| File | View File |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role | Address |
|---|---|---|
| Howe Henry | President | 20 Burton Hills Blvd, Nashville, TN, 37215 |
| Name | Role | Address |
|---|---|---|
| Marcus Jillian | Secretary | 20 Burton Hills Blvd, Nashville, TN, 37215 |
| Name | Role | Address |
|---|---|---|
| Cross William | Treasurer | 20 Burton Hills Blvd, Nashville, TN, 37215 |
| Name | Role | Address |
|---|---|---|
| Musso Matthew | Vice President | 20 Burton Hills Blvd, Nashville, TN, 37215 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000068104 | ENVISION PHYSICIAN SERVICES | ACTIVE | 2017-06-21 | 2027-12-31 | No data | 1A BURTON HILLS BOULEVARD, NASHVILLE, TN, 37215 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-20 | 20 Burton Hills Blvd, Suite 500, Nashville, TN 37215 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-20 | 20 Burton Hills Blvd, Suite 500, Nashville, TN 37215 | No data |
| REGISTERED AGENT NAME CHANGED | 2017-05-31 | CORPORATION SERVICE COMPANY | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-05-31 | 1201 HAYS STREET, TALLAHASSEE, FL 32301-2525 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-20 |
| ANNUAL REPORT | 2023-04-25 |
| ANNUAL REPORT | 2022-04-22 |
| ANNUAL REPORT | 2021-02-11 |
| ANNUAL REPORT | 2020-06-29 |
| ANNUAL REPORT | 2019-04-24 |
| ANNUAL REPORT | 2018-04-25 |
| Reg. Agent Change | 2017-05-31 |
| ANNUAL REPORT | 2017-04-25 |
| AMENDED ANNUAL REPORT | 2016-10-20 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
