| Entity Name: | ADVANCED INTERNAL MEDICINE, L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 01 Aug 2002 (23 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 03 Aug 2015 (10 years ago) |
| Document Number: | L02000019609 |
| FEI/EIN Number | 820556723 |
| Address: | 601 UNIVERSITY BLVD, 105, JUPITER, FL, 33458, US |
| Mail Address: | 601 UNIVERSITY BLVD, 105, JUPITER, FL, 33458, US |
| ZIP code: | 33458 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1356496137 | 2007-01-24 | 2011-06-20 | 601 UNIVERSITY BOULEVARD, SUITE 105, JUPITER, FL, 33458, US | 601 UNIVERSITY BLVD, SUITE 105, JUPITER, FL, 33458, US | |||||||||||||||||||||||||||||||||
|
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| Phone | +1 561-625-9575 |
| Fax | 5616259533 |
Authorized person
| Name | DR. SALUJA VARGHESE |
| Role | OWNER |
| Phone | 5616259575 |
Taxonomy
| Taxonomy Code | 202K00000X - Phlebology Physician |
| License Number | ME85291 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME86718 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PALMETTO MC |
| Number | P00083413 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GOLDMAN ALEXANDER | Agent | 601 UNIVERSITY BLVD, JUPITER, FL, 33458 |
| Name | Role |
|---|---|
| AGVI MANAGEMENT, LLC | Auth |
| SGVI MANAGEMENT, LLC | Auth |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000155586 | BODY BY GOLDMAN | ACTIVE | 2020-12-08 | 2025-12-31 | No data | 601 UNIVERSITY BLVD, SUITE 105, JUPITER, FL, 33458 |
| G09000164657 | GOLDMAN VEIN INSTITUTE | ACTIVE | 2009-10-13 | 2029-12-31 | No data | 601 UNIVERSITY BLVD, SUITE 105, JUPITER, FL, 33458 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2015-08-03 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2012-04-10 | GOLDMAN, ALEXANDER | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2007-04-30 | 601 UNIVERSITY BLVD, 105, JUPITER, FL 33458 | No data |
| CHANGE OF MAILING ADDRESS | 2007-04-30 | 601 UNIVERSITY BLVD, 105, JUPITER, FL 33458 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2007-04-30 | 601 UNIVERSITY BLVD, 105, JUPITER, FL 33458 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-04 |
| ANNUAL REPORT | 2023-04-12 |
| ANNUAL REPORT | 2022-04-28 |
| ANNUAL REPORT | 2021-04-14 |
| ANNUAL REPORT | 2020-06-15 |
| ANNUAL REPORT | 2019-04-29 |
| ANNUAL REPORT | 2018-04-26 |
| ANNUAL REPORT | 2017-04-05 |
| ANNUAL REPORT | 2016-04-20 |
| LC Amendment | 2015-08-03 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
