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  5. FAMILY MEDICINE OF WESTON LLC

FAMILY MEDICINE OF WESTON LLC

Company Details

Entity Name: FAMILY MEDICINE OF WESTON LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 26 Apr 2006 (19 years ago)
Document Number: L06000043182
FEI/EIN Number 204767315
Address: 2625 Executive Park Dr Suite 3, Weston, FL, 33331, US
Mail Address: 2625 Executive Park Dr Suite 3, Weston, FL, 33331, US
ZIP code: 33331
County: Broward
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1447346333 2006-10-05 2008-03-21 2300 N COMMERCE PKWY, SUITE 315, WESTON, FL, 333263254, US 2300 N COMMERCE PKWY, SUITE 315, WESTON, FL, 333263254, US

Contacts
Phone +1 954-217-3354

Authorized person
Name ALBERTO RENGIFO
Role MD
Phone 9542173354

Taxonomy
Taxonomy Code 207Q00000X - Family Medicine Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FAMILY MEDICINE OF WESTON 401(K) PLAN 2023 204767315 2024-09-06 FAMILY MEDICINE OF WESTON 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 9542171442
Plan sponsor’s address 2625 EXECUTIVE PARK DRIVE, SUITE 3, WESTON, FL, 33331
FAMILY MEDICINE OF WESTON 401(K) PLAN 2022 204767315 2023-08-15 FAMILY MEDICINE OF WESTON 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 9542171442
Plan sponsor’s address 2300 NORTH COMMERCE PARKWAY, SUITE 317, WESTON, FL, 33326
FAMILY MEDICINE OF WESTON 401(K) PLAN 2021 204767315 2022-10-04 FAMILY MEDICINE OF WESTON 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 9542171442
Plan sponsor’s address 2300 NORTH COMMERCE PARKWAY, SUITE 317, WESTON, FL, 33326
FAMILY MEDICINE OF WESTON 401(K) PLAN 2020 204767315 2021-09-23 FAMILY MEDICINE OF WESTON 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 9542171442
Plan sponsor’s address 2300 NORTH COMMERCE PARKWAY, SUITE 317, WESTON, FL, 33326

Signature of
Role Plan administrator
Date 2021-09-23
Name of individual signing CLAUDIA RENGIFO
Valid signature Filed with authorized/valid electronic signature
FAMILY MEDICINE OF WESTON 401(K) PLAN 2019 204767315 2020-10-13 FAMILY MEDICINE OF WESTON, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 9542171442
Plan sponsor’s address 2300 NORTH COMMERCE PKWY, SUITE 317, WESTON, FL, 33326

Signature of
Role Plan administrator
Date 2020-10-13
Name of individual signing ASCENSUS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-10-13
Name of individual signing CLAUDIA RENGIFO
Valid signature Filed with authorized/valid electronic signature
FAMILY MEDICINE OF WESTON 401(K) PLAN 2018 204767315 2019-09-23 FAMILY MEDICINE OF WESTON, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 9542171442
Plan sponsor’s address 2300 NORTH COMMERCE PKWY, SUITE 317, WESTON, FL, 33326

Signature of
Role Plan administrator
Date 2019-09-23
Name of individual signing CLAUDIA RENGIFO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-09-23
Name of individual signing FAMILY MEDICINE OF WESTON
Valid signature Filed with authorized/valid electronic signature
FAMILY MEDICINE OF WESTON 401(K) PLAN 2017 204767315 2018-10-15 FAMILY MEDICINE OF WESTON, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 9542171442
Plan sponsor’s address 2300 NORTH COMMERCE PKWY, SUITE 310, WESTON, FL, 33326

Signature of
Role Plan administrator
Date 2018-10-15
Name of individual signing CLAUDIA MURILLO RENGIFO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-10-15
Name of individual signing CLAUDIA MURILLO RENGIFO
Valid signature Filed with authorized/valid electronic signature
FAMILY MEDICINE OF WESTON 401(K) PLAN 2016 204767315 2017-10-16 FAMILY MEDICINE OF WESTON, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 9542171442
Plan sponsor’s address 2300 NORTH COMMERCE PKWY, SUITE 310, WESTON, FL, 33326

Signature of
Role Plan administrator
Date 2017-10-16
Name of individual signing CLAUDIA RENGIFO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-10-16
Name of individual signing CLAUDIA RENGIFO
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
MURILLO RENGIFO CLAUDIA P Agent 2625 Executive Park Dr Suite 3, Weston, FL, 33331

Managing Member

Name Role Address
RENGIFO ALBERTO Managing Member 2300 N COMMERCE PKWY STE 317, WESTON, FL, 33326
MURILLO RENGIFO CLAUDIA P Managing Member 2300 N COMMERCE PKWY STE 317, WESTON, FL, 33326

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2023-04-28 2625 Executive Park Dr Suite 3, Weston, FL 33331 No data
CHANGE OF MAILING ADDRESS 2023-04-28 2625 Executive Park Dr Suite 3, Weston, FL 33331 No data
REGISTERED AGENT ADDRESS CHANGED 2023-04-28 2625 Executive Park Dr Suite 3, Weston, FL 33331 No data

Documents

Name Date
ANNUAL REPORT 2024-04-04
ANNUAL REPORT 2023-04-28
ANNUAL REPORT 2022-04-21
ANNUAL REPORT 2021-04-09
ANNUAL REPORT 2020-06-23
ANNUAL REPORT 2019-04-29
ANNUAL REPORT 2018-04-30
ANNUAL REPORT 2017-04-27
ANNUAL REPORT 2016-04-18
ANNUAL REPORT 2015-04-21

Related by officers

RENGIFO ALBERTO

ALLIANCE PRIMARY CARE, LLC SANDAMAJU INVESTMENTS, LLC CLESER LLC CONSERVATION HEALTH SERVICES, LLC

Related by address

2625 Executive Park Dr Suite 3, Weston, FL, 33331, US

ALLIANCE PRIMARY CARE, LLC

2625 Executive Park Dr Suite 3, Weston, FL, 33331, US

ALLIANCE PRIMARY CARE, LLC

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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