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  5. PCCC OF VOLUSIA LLC

PCCC OF VOLUSIA LLC - Florida Company Profile

Company Details

Entity Name: PCCC OF VOLUSIA LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

PCCC OF VOLUSIA LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 26 Jan 2004 (21 years ago)
Last Event: LC STMNT OF AUTHORITY 21
Event Date Filed: 20 Jan 2015 (10 years ago)
Document Number: L04000006637
FEI/EIN Number 200604706

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 1055 North Dixie Freeway, New Smyrna Beach, FL, 32168, US
Mail Address: 1055 North Dixie Freeway, New Smyrna Beach, FL, 32168, US
ZIP code: 32168
County: Volusia
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1285685370 2006-05-13 2008-04-20 1055 N DIXIE FWY, SUITE 1, NEW SMYRNA BEACH, FL, 321686201, US 1055 N DIXIE FWY, SUITE 1, NEW SMYRNA BEACH, FL, 321686201, US

Contacts
Phone +1 386-423-0505
Fax 3864230515

Authorized person
Name RAJESH K AILANI
Role MD
Phone 3864230505

Taxonomy
Taxonomy Code 207RC0200X - Critical Care Medicine (Internal Medicine) Physician
License Number ME89115
State FL
Is Primary No
Taxonomy Code 207RP1001X - Pulmonary Disease Physician
License Number ME89115
State FL
Is Primary Yes
Taxonomy Code 207RS0012X - Sleep Medicine (Internal Medicine) Physician
Is Primary No

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PCCC OF VOLUSIA, LLC 401(K) PROFIT SHARING PLAN 2023 200604706 2024-05-31 PCCC OF VOLUSIA, LLC 123
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 3865896409
Plan sponsor’s address 1055 N. DIXIE FREEWAY, SUITE 1, NEW SMYRNA BEACH, FL, 32168

Signature of
Role Plan administrator
Date 2024-05-31
Name of individual signing RAJESH K. AILANI
Valid signature Filed with authorized/valid electronic signature
PCCC OF VOLUSIA, LLC 401(K) PROFIT SHARING PLAN 2022 200604706 2023-07-05 PCCC OF VOLUSIA, LLC 91
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 3865896409
Plan sponsor’s address 1055 N. DIXIE FREEWAY, SUITE 1, NEW SMYRNA BEACH, FL, 32168

Signature of
Role Plan administrator
Date 2023-07-05
Name of individual signing RAJESH K. AILANI
Valid signature Filed with authorized/valid electronic signature
PCCC OF VOLUSIA, LLC 401(K) PROFIT SHARING PLAN 2021 200604706 2022-05-19 PCCC OF VOLUSIA, LLC 75
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 3865896409
Plan sponsor’s address 1055 N. DIXIE FREEWAY, SUITE 1, NEW SMYRNA BEACH, FL, 32168

Signature of
Role Plan administrator
Date 2022-05-19
Name of individual signing RAJESH K. AILANI
Valid signature Filed with authorized/valid electronic signature
PCCC OF VOLUSIA, LLC 401(K) PROFIT SHARING PLAN 2020 200604706 2021-07-30 PCCC OF VOLUSIA, LLC 61
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 3865896409
Plan sponsor’s address 1055 N. DIXIE FREEWAY, SUITE 1, NEW SMYRNA BEACH, FL, 32168

Signature of
Role Plan administrator
Date 2021-07-30
Name of individual signing RAJESH K. AILANI
Valid signature Filed with authorized/valid electronic signature
PCCC OF VOLUSIA, LLC 401(K) PROFIT SHARING PLAN 2019 200604706 2020-07-24 PCCC OF VOLUSIA, LLC 43
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 3865896409
Plan sponsor’s address 1055 N. DIXIE FREEWAY, SUITE 1, NEW SMYRNA BEACH, FL, 32168
PCCC OF VOLUSIA, LLC 401(K) PROFIT SHARING PLAN 2018 200604706 2019-07-01 PCCC OF VOLUSIA, LLC 50
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 3865896409
Plan sponsor’s address 1055 N. DIXIE FREEWAY, SUITE 1, NEW SMYRNA BEACH, FL, 32168
PCCC OF VOLUSIA, LLC 401(K) PROFIT SHARING PLAN 2017 200604706 2018-06-05 PCCC OF VOLUSIA, LLC 54
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 3865896409
Plan sponsor’s address 1055 N. DIXIE FREEWAY, SUITE 1, NEW SMYRNA BEACH, FL, 32168
PCCC OF VOLUSIA, LLC 401(K) PROFIT SHARING PLAN 2016 200604706 2017-09-15 PCCC OF VOLUSIA, LLC 53
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 3865896409
Plan sponsor’s address 1055 N. DIXIE FREEWAY, SUITE 1, NEW SMYRNA BEACH, FL, 32168
PCCC OF VOLUSIA, LLC 401(K) PROFIT SHARING PLAN 2015 200604706 2016-09-30 PCCC OF VOLUSIA, LLC 48
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 3865896409
Plan sponsor’s address 1055 N. DIXIE FREEWAY, SUITE 1, NEW SMYRNA BEACH, FL, 32168
PCCC OF VOLUSIA, LLC 401 (K) PROFIT SHARING PLAN & TRUST 2014 200604706 2015-08-19 PCCC OF VOLUSIA, LLC 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 3865896409
Plan sponsor’s address 1055 N. DIXIE FREEWAY, STE 1, NEW SMYRNA BEACH, FL, 32168

Signature of
Role Plan administrator
Date 2015-08-19
Name of individual signing RAJESH K. AILANI
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
AILANI RAJESH Managing Member 1055 North Dixie Freeway, New Smyrna Beach, FL, 32168
AILANI RAJESH K Agent 1055 North Dixie Freeway, New Smyrna Beach, FL, 32168

Events

Event Type Filed Date Value Description
LC STMNT OF AUTHORITY 2015-01-20 - -
CHANGE OF PRINCIPAL ADDRESS 2013-04-21 1055 North Dixie Freeway, New Smyrna Beach, FL 32168 -
CHANGE OF MAILING ADDRESS 2013-04-21 1055 North Dixie Freeway, New Smyrna Beach, FL 32168 -
REGISTERED AGENT ADDRESS CHANGED 2013-04-21 1055 North Dixie Freeway, New Smyrna Beach, FL 32168 -
REGISTERED AGENT NAME CHANGED 2005-01-21 AILANI, RAJESH K -

Documents

Name Date
ANNUAL REPORT 2024-04-02
ANNUAL REPORT 2023-03-15
ANNUAL REPORT 2022-03-15
ANNUAL REPORT 2021-03-31
ANNUAL REPORT 2020-05-20
ANNUAL REPORT 2019-04-10
ANNUAL REPORT 2018-01-29
ANNUAL REPORT 2017-05-02
ANNUAL REPORT 2016-04-30
ANNUAL REPORT 2015-04-29

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
3374637102 2020-04-11 0491 PPP 1055 DIXIE FWY, NEW SMYRNA BEACH, FL, 32168
Loan Status Date 2021-04-20
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 675000
Loan Approval Amount (current) 675000
Undisbursed Amount 0
Franchise Name -
Lender Location ID 58036
Servicing Lender Name Fifth Third Bank
Servicing Lender Address 38 Fountain Sq Plz, CINCINNATI, OH, 45263
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address NEW SMYRNA BEACH, VOLUSIA, FL, 32168-0001
Project Congressional District FL-07
Number of Employees 56
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 58036
Originating Lender Name Fifth Third Bank
Originating Lender Address CINCINNATI, OH
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 681318.75
Forgiveness Paid Date 2021-03-24

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BRILLIANCE NORTH DIXIE LLC - Active
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BRILLIANCE NORTH DIXIE LLC - Active
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RAJRINURISHI LLC - Inactive
Florida Limited Liability Co. (2020 - 2021)
RAJRINURISHI LLC - Inactive
Florida Limited Liability Co. (2020 - 2021)
NCCC OF VOLUSIA LLC - Active
Florida Limited Liability Co. (2023 )
NCCC OF VOLUSIA LLC - Active
Florida Limited Liability Co. (2023 )
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AILANI RAJESH K

RAJREBA FAMILY LIMITED PARTNERSHIP - Active
Domestic Limited Partnership (2005 )
RAJREBA FAMILY LIMITED PARTNERSHIP - Active
Domestic Limited Partnership (2005 )
PORT ORANGE MEDICAL AND PROFESSIONAL CENTER ASSOCIATION, INC. - Active
Domestic Non-Profit (2009 )
PORT ORANGE MEDICAL AND PROFESSIONAL CENTER ASSOCIATION, INC. - Active
Domestic Non-Profit (2009 )
PMC OF VOLUSIA, LLC - Active
Florida Limited Liability Co. (2012 )
PMC OF VOLUSIA, LLC - Active
Florida Limited Liability Co. (2012 )
PCCC OF PORT ORANGE AND ORMOND LLC - Active
Florida Limited Liability Co. (2007 )
PCCC OF PORT ORANGE AND ORMOND LLC - Active
Florida Limited Liability Co. (2007 )

Companies related by address

1055 North Dixie Freeway, New Smyrna Beach, FL, 32168, US

EAGLE HEALTH PARTNERS LLC RAJREBA FAMILY LIMITED PARTNERSHIP AILANI NORTH DIXIE, LLC PCCC OF PORT ORANGE AND ORMOND LLC

1055 North Dixie Freeway, New Smyrna Beach, FL, 32168, US

EAGLE HEALTH PARTNERS LLC RAJREBA FAMILY LIMITED PARTNERSHIP AILANI NORTH DIXIE, LLC PCCC OF PORT ORANGE AND ORMOND LLC

Date of last update: 02 Mar 2025

Sources: Florida Department of State

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