| Entity Name: | BIRCHES HEALTH MEDICAL GROUP, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 16 Feb 2024 (a year ago) |
| Document Number: | P24000012936 |
| Address: | 100 S. ASHLEY DRIVE, SUITE 600, TAMPA, FL, 33602, US |
| Mail Address: | 100 S. ASHLEY DRIVE, SUITE 600, TAMPA, FL, 33602, US |
| ZIP code: | 33602 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| Type | Company Name | Company Number | State |
|---|---|---|---|
| Headquarter of | BIRCHES HEALTH MEDICAL GROUP, P.A., COLORADO | 20241298841 | COLORADO |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1366292005 | 2024-03-25 | 2024-06-13 | 100 S ASHLEY DR STE 600, TAMPA, FL, 336025300, US | 100 S ASHLEY DR STE 600, TAMPA, FL, 336025300, US | |||||||||||||
|
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| Phone | +1 833-483-3838 |
Authorized person
| Name | ELLIOTT RAPAPORT |
| Role | AUTHORIZED OFFICIAL |
| Phone | 9178438445 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | Yes |
| Name | Role |
|---|---|
| REGIONAL MEDICAL HEALTH SERVICES, P.A. | Agent |
| Name | Role | Address |
|---|---|---|
| ESTERMAN BRADLEY JAY | Director | 7531 ESTRELLA CIRCLE, BOCA RATON, FL, 33433 |
| Name | Date |
|---|---|
| Domestic Profit | 2024-02-16 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
