| Entity Name: | SOUTHWEST ORLANDO FAMILY MEDICINE, P.L. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 24 Oct 2002 (22 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 31 Jul 2020 (5 years ago) |
| Document Number: | L02000028326 |
| FEI/EIN Number | 061654176 |
| Address: | 7400 DOCS GROVE CIRCLE, ORLANDO, FL, 32819, US |
| Mail Address: | 7400 DOCS GROVE CIRCLE, ORLANDO, FL, 32819, US |
| ZIP code: | 32819 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538237615 | 2006-11-30 | 2014-01-15 | 7400 DOCS GROVE CIR, ORLANDO, FL, 328198010, US | 7400 DOCS GROVE CIR, ORLANDO, FL, 328198010, US | |||||||||||||||||||||
|
|||||||||||||||||||||||||
| Phone | +1 407-352-9717 |
| Fax | 4073545425 |
Authorized person
| Name | MELIZA GONZALES |
| Role | OFFICE MANAGER |
| Phone | 4073529717 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 375198810 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Gonzales Meliza C | Agent | 7400 DOCS GROVE CIRCLE, ORLANDO, FL, 32819 |
| Name | Role | Address |
|---|---|---|
| GONZALES PATRICK P | Manager | 7400 DOCS GROVE CIRCLE, ORLANDO, FL, 32819 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000120755 | SOUTHWEST ORLANDO FAMILY MEDICINE | EXPIRED | 2018-11-09 | 2023-12-31 | No data | 7400 DOCS GROVE CIRCLE, ORLANDO, FL, 32819 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2021-02-11 | Gonzales, Meliza C | No data |
| LC AMENDMENT | 2020-07-31 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-03-19 | 7400 DOCS GROVE CIRCLE, ORLANDO, FL 32819 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-01-20 | 7400 DOCS GROVE CIRCLE, ORLANDO, FL 32819 | No data |
| CHANGE OF MAILING ADDRESS | 2009-01-20 | 7400 DOCS GROVE CIRCLE, ORLANDO, FL 32819 | No data |
| CANCEL ADM DISS/REV | 2004-11-19 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2004-10-01 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-18 |
| ANNUAL REPORT | 2023-01-29 |
| ANNUAL REPORT | 2022-02-15 |
| ANNUAL REPORT | 2021-02-11 |
| LC Amendment | 2020-07-31 |
| ANNUAL REPORT | 2020-05-21 |
| ANNUAL REPORT | 2019-02-12 |
| ANNUAL REPORT | 2018-01-22 |
| ANNUAL REPORT | 2017-01-23 |
| ANNUAL REPORT | 2016-01-25 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 8679577101 | 2020-04-15 | 0491 | PPP | 7400 Docs Grove Cir, ORLANDO, FL, 32819 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Date of last update: 02 Feb 2025
Sources: Florida Department of State
