| Entity Name: | FERNHILL FAMILY MEDICINE L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
FERNHILL FAMILY MEDICINE L.L.C. 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. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 03 May 2004 (21 years ago) |
| Date of dissolution: | 27 Sep 2024 (7 months ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2024 (7 months ago) |
| Document Number: | L04000035649 |
| FEI/EIN Number |
510508741
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 1879 NIGHTINGALE LANE, SUITE # B3, TAVARES, FL, 32778-4363, US |
| Mail Address: | P.O. BOX 396, MOUNT DORA, FL, 32756-0396 |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1871641209 | 2007-01-08 | 2010-10-26 | 4601 N HIGHWAY 19A, MOUNT DORA, FL, 327572039, US | 4601 N HIGHWAY 19A, MOUNT DORA, FL, 327572039, US | |||||||||||||||||||||||||
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| Phone | +1 352-589-9090 |
| Fax | 3525891433 |
Authorized person
| Name | DR. KUMARAN KONDATH MOHAN |
| Role | DIRECT OWNER |
| Phone | 3525899090 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ME 83819 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 265990500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MOHAN KUMARAN K | Manager | 2306 GABLES DRIVE, EUSTIS, FL, 327262080 |
| MOHAN KUMARAN K | Agent | 2306 GABLES DRIVE, EUSTIS, FL, 327262080 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2016-03-13 | 1879 NIGHTINGALE LANE, SUITE # B3, TAVARES, FL 32778-4363 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2023-03-12 |
| ANNUAL REPORT | 2022-02-21 |
| ANNUAL REPORT | 2021-01-26 |
| ANNUAL REPORT | 2020-04-06 |
| ANNUAL REPORT | 2019-02-05 |
| ANNUAL REPORT | 2018-02-06 |
| ANNUAL REPORT | 2017-02-13 |
| ANNUAL REPORT | 2016-03-13 |
| ANNUAL REPORT | 2015-03-04 |
| ANNUAL REPORT | 2014-04-29 |
Date of last update: 03 Apr 2025
Sources: Florida Department of State
