Detail by Officer/Registered Agent Name

Florida Limited Liability Company

PHYSICIANS COLLABORATIVE, L.C.

Filing Information
L95000000217 NONE 03/17/1995 FL INACTIVE ADMIN DISSOLUTION FOR ANNUAL REPORT 08/23/1996 NONE
Principal Address
1370 13TH AVENUE SOUTH
SUITE 214
JACKSONVILLE BEACH, FL 32250
Mailing Address
1370 13TH AVENUE SOUTH
SUITE 214
JACKSONVILLE BEACH, FL 32250
Registered Agent Name & Address BURAK, CARL SMD
1370 13TH AVENUE SOUTH
SUITE 214
JACKSONVILLE BEACH, FL 32250
Authorized Person(s) Detail Name & Address

Title MGRM

BURAK, CARL S
1370 13TH AVENUE SOUTH SUITE 214
JACKSONVILLE BEACH, FL 32250

Title MGRM

PATHAK, ANJALI A
836 PRUDENTIAL DRIVE SUITE 1705
JACKSONVILLE, FL 32207

Title MGRM

WIKSTROM, THOMAS R
836 PRUDENTIAL DRIVE SUITE 1006
JACKSONVILLE, FL 32207

Title MGRM

OREA, DAVID A
4130 SALISBURY RD SUITE 1200
JACKSONVILLE, FL 32216

Title MGRM

SHAH, ATUL M
1545 HUFFINGHAM RD
JACKSONVILLE, FL 32216

Title MGRM

CARLOS, PERRY G
3649 CROWN POINT CT
JACKSONVILLE, FL 32257

Annual Reports
No Annual Reports Filed