| Entity Name: | NIGHT LITE PEDIATRIC CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 30 Oct 2002 (22 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 04 Sep 2024 (5 months ago) |
| Document Number: | L02000028969 |
| FEI/EIN Number | 270034858 |
| Address: | One Hollow Lane, Lake Success, NY, 11042, US |
| Mail Address: | One Hollow Lane, Lake Success, NY, 11042, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508526435 | 2021-12-20 | 2023-10-31 | 5900 S JOHN YOUNG PKWY, ORLANDO, FL, 328393716, US | 5900 S JOHN YOUNG PKWY, ORLANDO, FL, 328393716, US | |||||||||||||||||||
|
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| Phone | +1 407-398-6470 |
Authorized person
| Name | LINDA CHEN |
| Role | PRESIDENT |
| Phone | 8002433839 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 113228400 |
| State | FL |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role |
|---|---|
| PM PEDIATRICS MANAGEMENT GROUP, LLC | Authorized Member |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000079379 | PM PEDIATRIC URGENT CARE | ACTIVE | 2024-07-01 | 2029-12-31 | No data | ONE HOLLOW LANE, SUITE 301, LAKE SUCCESS, NY, 11042 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-10-15 | One Hollow Lane, Suite 301, Lake Success, NY 11042 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-10-15 | One Hollow Lane, Suite 301, Lake Success, NY 11042 | No data |
| LC AMENDMENT | 2024-09-04 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-07-19 | 1201 HAYS STREET, TALLAHASSEE, FL 32301 | No data |
| LC STMNT OF RA/RO CHG | 2024-07-19 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2024-07-19 | CORPORATION SERVICE COMPANY | No data |
| LC AMENDMENT | 2022-01-31 | No data | No data |
| REINSTATEMENT | 2020-11-11 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| LC AMENDMENT | 2012-08-23 | No data | 5/24/11 MERGER "VOID" DUE TO IMAGED DOCUMENTATION AND 1983 ADMIN. HEAR ING DECISION RE: CASE #83-282 |
| Name | Date |
|---|---|
| LC Amendment | 2024-09-04 |
| CORLCRACHG | 2024-07-19 |
| ANNUAL REPORT | 2024-04-25 |
| ANNUAL REPORT | 2023-05-02 |
| LC Amendment | 2022-01-31 |
| ANNUAL REPORT | 2022-01-26 |
| ANNUAL REPORT | 2021-02-02 |
| REINSTATEMENT | 2020-11-11 |
| ANNUAL REPORT | 2019-06-10 |
| ANNUAL REPORT | 2018-04-10 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
