Detail by Officer/Registered Agent Name

Florida Limited Liability Company

SUMMIT PROVIDER SERVICES LLC

Filing Information
L20000013479 84-4399390 01/07/2020 01/01/2020 FL ACTIVE
Principal Address
400 Health Pk Blvd
Mental Health Unit
SAINT AUGUSTINE, FL 32086

Changed: 01/24/2021
Mailing Address
400 Health Pk Blvd
Mental Health Unit
SAINT AUGUSTINE, FL 32086

Changed: 01/24/2021
Registered Agent Name & Address BRODER, TODD
17 Saint Johns Medical Park Dr
Saint Augustine, FL 32086

Address Changed: 02/16/2022
Authorized Person(s) Detail Name & Address

Title MGR

Broder, Todd
17 Saint Johns Medical Park Dr
Mental Health Unit
Saint Augustine, FL 32086

Annual Reports
Report YearFiled Date
2022 02/16/2022
2023 07/11/2023
2024 01/22/2024