| Entity Name: | MEDCARE DIABETIC SUPPLY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 16 Jul 2004 (21 years ago) |
| Date of dissolution: | 30 Apr 2012 (13 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 30 Apr 2012 (13 years ago) |
| Document Number: | L04000053674 |
| FEI/EIN Number | 201333590 |
| Address: | 29 ENTERPRISE DR., STE B, BUNNELL, FL, 32110, US |
| Mail Address: | 29 ENTERPRISE DR., STE B, BUNNELL, FL, 32110, US |
| ZIP code: | 32110 |
| County: | Flagler |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1194868984 | 2007-02-14 | 2010-07-28 | 29 ENTERPRISE DR, SUITE B, BUNNELL, FL, 321104302, US | 29 ENTERPRISE DR, SUITE B, BUNNELL, FL, 321104302, US | |||||||||||||||||||||||||
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| Phone | +1 386-206-4844 |
| Fax | 3862064413 |
Authorized person
| Name | MS. CATHERINE MCVEIGH |
| Role | GENERAL MANAGER-MGR.MEMBER |
| Phone | 3862064844 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | 1312982 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 031790000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ROBERTI GERALD | Agent | 6136 VISTA LINDA LANE, BOCA RATON, FL, 33433 |
| Name | Role | Address |
|---|---|---|
| GERALD ROBERTI | Managing Member | 6136 VISTA LINDA LANE, BOCA RATON, FL, 33433 |
| CATHERINE MCVEIGH GANEM L | Managing Member | 156 BELLEAIRE DRIVE, PALM COAST, FL, 32137 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2012-04-30 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-06-04 | 29 ENTERPRISE DR., STE B, BUNNELL, FL 32110 | No data |
| CHANGE OF MAILING ADDRESS | 2010-06-04 | 29 ENTERPRISE DR., STE B, BUNNELL, FL 32110 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-05-01 | 6136 VISTA LINDA LANE, BOCA RATON, FL 33433 | No data |
| REGISTERED AGENT NAME CHANGED | 2005-04-27 | ROBERTI, GERALD | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J11000830963 | TERMINATED | 1000000242344 | FLAGLER | 2011-12-01 | 2021-12-21 | $ 467.75 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, DAYTONA BEACH SERVICE CENTER, 1180 N WILLIAMSON BLVD STE 160, DAYTONA BEACH FL321148179 |
| J11000261680 | LAPSED | 2010-CC-669 | FLAGLER COUNTY COURT | 2011-03-25 | 2016-04-27 | $16,901.96 | YELLOW BOOK SALES AND DISTRIBUTION COMPANY, INC., C/O SPRECHMAN & ASSOCIATES, P.A., 2775 SUNNY ISLES BLVD #100, NORTH MIAMI BEACH, FL 33160 |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2012-04-30 |
| ANNUAL REPORT | 2011-05-01 |
| ADDRESS CHANGE | 2010-06-04 |
| ANNUAL REPORT | 2010-05-01 |
| ADDRESS CHANGE | 2010-04-05 |
| ADDRESS CHANGE | 2009-09-14 |
| ANNUAL REPORT | 2009-04-28 |
| ANNUAL REPORT | 2008-05-01 |
| ANNUAL REPORT | 2007-03-09 |
| ANNUAL REPORT | 2006-01-04 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
