| Entity Name: | BRANDON PREMIER HEALTHCARE, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 26 Feb 2003 (22 years ago) |
| Last Event: | NAME CHANGE AMENDMENT |
| Event Date Filed: | 13 Feb 2017 (8 years ago) |
| Document Number: | P03000023125 |
| FEI/EIN Number | 56-2320340 |
| Address: | 907 N PARSONS AVE, BRANDON, FL 33510 |
| Mail Address: | 907 N PARSONS AVE, BRANDON, FL 33510 |
| ZIP code: | 33510 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548463599 | 2007-06-07 | 2017-07-28 | 907 N PARSONS AVE, BRANDON, FL, 335103107, US | 907 N PARSONS AVE, BRANDON, FL, 335103107, US | |||||||||||||||||||||||||||||
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| Phone | +1 813-689-8020 |
| Fax | 8136898381 |
Authorized person
| Name | MRS. HILLARY LISSORN MORGAN |
| Role | PRESIDENT |
| Phone | 8136898020 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| License Number | 2750432 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 274805300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MORGAN, HILLARY | Agent | 907 N PARSONS AVE, BRANDON, FL 33510 |
| Name | Role | Address |
|---|---|---|
| MORGAN, HILLARY | President | 907 N PARSONS AVE, SEFFNER, FL 33510 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| NAME CHANGE AMENDMENT | 2017-02-13 | BRANDON PREMIER HEALTHCARE, PA | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2011-02-21 | 907 N PARSONS AVE, BRANDON, FL 33510 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-02-21 | 907 N PARSONS AVE, BRANDON, FL 33510 | No data |
| CHANGE OF MAILING ADDRESS | 2011-02-21 | 907 N PARSONS AVE, BRANDON, FL 33510 | No data |
| REGISTERED AGENT NAME CHANGED | 2007-02-05 | MORGAN, HILLARY | No data |
| CANCEL ADM DISS/REV | 2007-02-05 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2005-09-16 | No data | No data |
| NAME CHANGE AMENDMENT | 2003-05-13 | SEFFNER PREMIER HEALTHCARE, P.A. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-16 |
| ANNUAL REPORT | 2023-04-25 |
| ANNUAL REPORT | 2022-04-12 |
| ANNUAL REPORT | 2021-07-27 |
| ANNUAL REPORT | 2020-03-03 |
| ANNUAL REPORT | 2019-06-22 |
| ANNUAL REPORT | 2018-02-15 |
| ANNUAL REPORT | 2017-03-22 |
| Name Change | 2017-02-13 |
| ANNUAL REPORT | 2016-04-06 |
Date of last update: 30 Jan 2025
Sources: Florida Department of State
