| Entity Name: | FLORIDA EM-I MEDICAL SERVICES, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 30 Dec 1997 (27 years ago) |
| Document Number: | P97000108784 |
| FEI/EIN Number | 752739410 |
| 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 | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1003633694 | 2024-09-24 | 2024-09-24 | PO BOX 80170, PHILADELPHIA, PA, 191011170, US | 6401 N FEDERAL HWY, FT LAUDERDALE, FL, 333081427, US | |||||||||||||||||||
|
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| Phone | +1 954-939-5000 |
| Fax | 8772506889 |
Authorized person
| Name | KAREN MARIE VAUGHN |
| Role | AUTHORIZED OFFICIAL |
| Phone | 4044504684 |
Taxonomy
| Taxonomy Code | 363A00000X - Physician Assistant |
| Is Primary | No |
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | Yes |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role | Address |
|---|---|---|
| BYRNE, M.D. GREGORY | President | 20 Burton Hills Blvd., NASHVILLE, TN, 37215 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G09000102007 | RADCARE OF FLORIDA | EXPIRED | 2009-04-29 | 2014-12-31 | No data | 1717 MAIN STREET,SUITE 5200, DALLAS, TX, 75201 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2001-10-26 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2001-09-21 | No data | No data |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
