| Entity Name: | BREVARD FAMILY WALK-IN CLINIC, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 08 Mar 2006 (19 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 06 Oct 2017 (7 years ago) |
| Document Number: | L06000024867 |
| FEI/EIN Number | 204661281 |
| Address: | 1950 ROCKLEDGE BLVD, SUITE 101, ROCKLEDGE, FL, 32955, US |
| Mail Address: | 1950 ROCKLEDGE BLVD, SUITE 101, ROCKLEDGE, FL, 32955, US |
| ZIP code: | 32955 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881008696 | 2014-06-19 | 2014-06-19 | 5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA, 921211705, US | 1205 N COURTENAY PKWY, MERRITT ISLAND, FL, 329535500, US | |||||||||||||||||
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| Phone | +1 321-636-0005 |
Authorized person
| Name | KENNY HEINE |
| Role | VP OF OPERATIONS |
| Phone | 8589641506 |
Taxonomy
| Taxonomy Code | 332900000X - Non-Pharmacy Dispensing Site |
| License Number | ME86649 |
| State | FL |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BREVARD FAMILY WALK-IN CLINIC, LLC 401(K) PLAN | 2023 | 204661281 | 2024-06-14 | BREVARD FAMILY WALK-IN CLINIC, LLC | 12 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-06-14 |
| Name of individual signing | JASEN KOBOBEL |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| KOBOBEL JASEN M | Agent | 1950 ROCKLEDGE BLVD, ROCKLEDGE, FL, 32955 |
| Name | Role | Address |
|---|---|---|
| KOBOBEL JASEN Dr. | President | 1950 ROCKLEDGE BLVD, STE 101, ROCKLEDGE, FL, 32955 |
| Name | Role | Address |
|---|---|---|
| KOBOBEL IZABELA | Vice President | 1950 ROCKLEDGE BLVD, STE 101, ROCKLEDGE, FL, 32955 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000102094 | NEXT GENERATION STEM CELL CLINIC | ACTIVE | 2020-08-11 | 2025-12-31 | No data | 1905 ROCKLEDGE BLVD, SUITE 101, ROCKLEDGE, FL, 32955 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2017-10-06 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2017-10-06 | KOBOBEL, JASEN MGR | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2009-10-16 | 1950 ROCKLEDGE BLVD, SUITE 101, ROCKLEDGE, FL 32955 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-10-16 | 1950 ROCKLEDGE BLVD, STE 101, ROCKLEDGE, FL 32955 | No data |
| CANCEL ADM DISS/REV | 2009-10-16 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-10-16 | 1950 ROCKLEDGE BLVD, SUITE 101, ROCKLEDGE, FL 32955 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J19000098036 | TERMINATED | 2018-CC-057225 | BREVARD COUNTY COURT | 2019-02-14 | 2024-02-14 | $6667.71 | HENRY SCHEIN, INC., C/O WILLIAM M. LINDEMAN, P.A., P.O. BOX 3506, ORLANDO, FL 32802 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-05-01 |
| ANNUAL REPORT | 2022-04-29 |
| ANNUAL REPORT | 2021-04-28 |
| ANNUAL REPORT | 2020-06-29 |
| ANNUAL REPORT | 2019-06-14 |
| ANNUAL REPORT | 2018-03-14 |
| REINSTATEMENT | 2017-10-06 |
| ANNUAL REPORT | 2016-04-26 |
| ANNUAL REPORT | 2015-03-25 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
