| Entity Name: | CARE LEVEL MANAGEMENT MEDICAL GROUP FLORIDA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 18 Feb 2003 (22 years ago) |
| Date of dissolution: | 26 Sep 2008 (16 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2008 (16 years ago) |
| Document Number: | L03000005958 |
| FEI/EIN Number | 320060512 |
| Address: | 1958 DAIRY RD, MELBOURNE, FL, 32904 |
| Mail Address: | 1958 DAIRY RD, MELBOURNE, FL, 32904 |
| ZIP code: | 32904 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063548287 | 2007-02-23 | 2020-08-22 | 5700 CANOGA AVE, SUITE 500, WOODLAND HILLS, CA, 913676579, US | 1958 DAIRY RD, MELBOURNE, FL, 329044045, US | |||||||||||||||||
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| Phone | +1 800-377-3606 |
| Fax | 8185958206 |
| Phone | +1 800-530-5441 |
Authorized person
| Name | RICHARD ST.ANDREW |
| Role | CREDENTIALING COORDINATOR |
| Phone | 8003773606 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| KHALIL RAOUF | Agent | 1958 DAIRY RD, MELBOURNE, FL, 32904 |
| Name | Role |
|---|---|
| CARE LEVEL MANAGEMENT LLC | Managing Member |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2008-09-26 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2007-06-18 | 1958 DAIRY RD, MELBOURNE, FL 32904 | No data |
| CHANGE OF MAILING ADDRESS | 2007-06-18 | 1958 DAIRY RD, MELBOURNE, FL 32904 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2007-06-18 | 1958 DAIRY RD, MELBOURNE, FL 32904 | No data |
| REINSTATEMENT | 2005-12-12 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2005-09-16 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2007-06-18 |
| ANNUAL REPORT | 2006-03-17 |
| REINSTATEMENT | 2005-12-12 |
| ANNUAL REPORT | 2004-02-18 |
| Florida Limited Liabilites | 2003-02-18 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
