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CRP PHYSICIAN SERVICES, INC - Florida Company Profile

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Company Details

Entity Name: CRP PHYSICIAN SERVICES, INC
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 22 Feb 2012 (14 years ago)
Date of dissolution: 25 Sep 2015 (10 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 25 Sep 2015 (10 years ago)
Document Number: P12000017764
FEI/EIN Number 45-4781004
Mail Address: P.O. BOX 14-4176, CORAL GABLES, FL, 33114, US
Address: 2069 SW 195 AVENUE, MIRAMAR, FL, 33029
ZIP code: 33029
City: Hollywood
County: Broward
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
SIERRA NILO Vice President 2069 SW 195 AVENUE, MIRAMAR, FL, 33029
WILSON KARREN E Agent 3849 BUCKINGHAMSHIRE DRIVE, LAND O LAKES, FL, 34638

National Provider Identifier

NPI Number:
1992129001

Authorized Person:

Name:
MR. NILO M SIERRA
Role:
VICE PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
302F00000X - Exclusive Provider Organization
Is Primary:
Yes

Contacts:

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2015-09-25 - -
CHANGE OF MAILING ADDRESS 2014-04-30 2069 SW 195 AVENUE, MIRAMAR, FL 33029 -

Documents

Name Date
ANNUAL REPORT 2014-04-30
ANNUAL REPORT 2013-04-29
Domestic Profit 2012-02-22

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Date of last update: 02 Aug 2025

Sources: Florida Department of State