| Entity Name: | FLEMING ISLAND FAMILY MEDICINE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 10 Nov 2005 (19 years ago) |
| Date of dissolution: | 06 Apr 2018 (7 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 06 Apr 2018 (7 years ago) |
| Document Number: | L05000109810 |
| FEI/EIN Number | 203786821 |
| Address: | 3189 US HWY 17, GREEN COVE SPRINGS, FL, 32043, US |
| Mail Address: | 3189 US HWY 17, GREEN COVE SPRINGS, FL, 32043 |
| ZIP code: | 32043 |
| County: | Clay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1578519518 | 2006-05-25 | 2012-06-05 | 3189 HIGHWAY 17, GREEN COVE SPRINGS, FL, 320439371, US | 3189 HIGHWAY 17, GREEN COVE SPRINGS, FL, 320439371, US | |||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||
| Phone | +1 904-529-2500 |
| Fax | 9045292509 |
Authorized person
| Name | DR. MELIA A EVANS |
| Role | PRESIDENT |
| Phone | 9045292500 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ME94840 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ME94745 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| EVANS MELIA A | Agent | 3189 US HWY 17, GREEN COVE SPRINGS, FL, 32043 |
| Name | Role | Address |
|---|---|---|
| EVANS MELIA M | Managing Member | 3189 US HWY 17, GREEN COVE SPRINGS, FL, 32043 |
| LEBEDA RAY M | Managing Member | 3189 US HWY 17, GREEN COVE SPRINGS, FL, 32043 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2018-04-06 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-04-25 | 3189 US HWY 17, GREEN COVE SPRINGS, FL 32043 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-04-23 | 3189 US HWY 17, GREEN COVE SPRINGS, FL 32043 | No data |
| CHANGE OF MAILING ADDRESS | 2011-11-15 | 3189 US HWY 17, GREEN COVE SPRINGS, FL 32043 | No data |
| REGISTERED AGENT NAME CHANGED | 2006-07-10 | EVANS, MELIA AR.A. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-04-06 |
| ANNUAL REPORT | 2017-01-10 |
| ANNUAL REPORT | 2016-03-29 |
| ANNUAL REPORT | 2015-02-20 |
| ANNUAL REPORT | 2014-02-04 |
| ANNUAL REPORT | 2013-04-25 |
| ANNUAL REPORT | 2012-04-23 |
| ANNUAL REPORT | 2011-03-29 |
| ANNUAL REPORT | 2010-04-30 |
| ANNUAL REPORT | 2009-03-10 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
