| Entity Name: | OAK GROVE PHYSICIAN SERVICES, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 12 Oct 2023 (a year ago) |
| Document Number: | P23000073105 |
| FEI/EIN Number | 93-3898773 |
| Address: | 200 CORPORATE BLVD, LAFAYETTE, LA, 70508 |
| Mail Address: | 200 CORPORATE BLVD, LAFAYETTE, LA, 70508 |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1689446700 | 2023-10-23 | 2023-10-23 | 200 CORPORATE BLVD, LAFAYETTE, LA, 705083870, US | 160 NW 170TH ST, NORTH MIAMI BEACH, FL, 331695521, US | |||||||||||||||||||||||||||
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| Phone | +1 800-893-9698 |
| Phone | +1 305-651-1100 |
Authorized person
| Name | DR. DAVID SCHILLINGER |
| Role | PRESIDENT/OWNER |
| Phone | 3376091221 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 208M00000X - Hospitalist Physician |
| Is Primary | No |
| Taxonomy Code | 363A00000X - Physician Assistant |
| Is Primary | No |
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | No |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| SCHILLINGER DAVID | President | 200 CORPORATE BLVD, LAFAYETTE, LA, 70508 |
| Name | Role | Address |
|---|---|---|
| SCHILLINGER DAVID | Secretary | 200 CORPORATE BLVD, LAFAYETTE, LA, 70508 |
| Name | Role | Address |
|---|---|---|
| SCHILLINGER DAVID | Treasurer | 200 CORPORATE BLVD, LAFAYETTE, LA, 70508 |
| Name | Role | Address |
|---|---|---|
| SCHILLINGER DAVID | Director | 200 CORPORATE BLVD, LAFAYETTE, LA, 70508 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-11 |
| Domestic Profit | 2023-10-12 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
