| Entity Name: | HAWTHORNE FAMILY PRACTICE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 27 Mar 2007 (18 years ago) |
| Date of dissolution: | 25 Sep 2009 (15 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2009 (15 years ago) |
| Document Number: | L07000032834 |
| FEI/EIN Number | 208780298 |
| Address: | 21815 SE 71ST AVENUE, HAWTHORNE, FL, 32640, US |
| Mail Address: | 21815 SE 71ST AVENUE, HAWTHORNE, FL, 32640, US |
| ZIP code: | 32640 |
| County: | Putnam |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245454586 | 2007-04-11 | 2007-07-19 | 21815 SE 71ST AVE, HAWTHORNE, FL, 326403974, US | 21815 SE 71ST AVE, HAWTHORNE, FL, 326403974, US | |||||||||||||||||||
|
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| Phone | +1 352-481-2400 |
| Fax | 3524812777 |
Authorized person
| Name | DR. ONA MARIE COLASANTE |
| Role | MEDICAL DOCTOR |
| Phone | 3524812400 |
Taxonomy
| Taxonomy Code | 305R00000X - Preferred Provider Organization |
| License Number | ME0063062 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| COLASANTE ONA | Agent | 21815 SE 71ST AVENUE, HAWTHORNE, FL, 32640 |
| Name | Role | Address |
|---|---|---|
| COLASANTE ONA | Managing Member | 21815 SE 71ST AVENUE, HAWTHORNE, FL, 32640 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2008-04-03 |
| Florida Limited Liability | 2007-03-27 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
