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  5. JACOB MEDICAL ASSOCIATES, LLC

JACOB MEDICAL ASSOCIATES, LLC - Florida Company Profile

Company Details

Entity Name: JACOB MEDICAL ASSOCIATES, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Company

JACOB MEDICAL ASSOCIATES, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 06 Apr 2007 (18 years ago)
Document Number: L07000036745
FEI/EIN Number 68-0647865

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 15725 willo pines lane, Montverde, FL 34756
Mail Address: 15725 willo pines lane, Montverde, FL 34756
ZIP code: 34756
County: Lake
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1174714414 2007-08-01 2013-06-11 426 DISSTON AVE, CLERMONT, FL, 347112633, US 426 DISSTON AVE, CLERMONT, FL, 347112633, US

Contacts
Phone +1 407-215-4999
Fax 8887623102

Authorized person
Name VIOLA M JACOB
Role MEDICAL DIRECTOR
Phone 3219466864

Taxonomy
Taxonomy Code 207RG0300X - Geriatric Medicine (Internal Medicine) Physician
License Number ME90116
State FL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 280396800
State FL
Issuer BC/BS
Number 43943
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
JACOB MEDICAL ASSOCIATES LLC 401(K) PLAN 2022 680647865 2023-09-28 JACOB MEDICAL ASSOCIATES LLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-08-01
Business code 621111
Sponsor’s telephone number 3219466864
Plan sponsor’s address 15725 WILLO PINES LN, MONTVERDE, FL, 34756

Signature of
Role Plan administrator
Date 2023-09-28
Name of individual signing VIOLA JACOB
Valid signature Filed with authorized/valid electronic signature
JACOB MEDICAL ASSOCIATES LLC 401(K) PLAN 2021 680647865 2022-08-01 JACOB MEDICAL ASSOCIATES LLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-08-01
Business code 621111
Sponsor’s telephone number 3219466864
Plan sponsor’s address 15725 WILLO PINES LN, MONTVERDE, FL, 34756

Signature of
Role Plan administrator
Date 2022-08-01
Name of individual signing VIOLA JACOB
Valid signature Filed with authorized/valid electronic signature
JACOB MEDICAL ASSOCIATES LLC 401(K) PLAN 2019 680647865 2020-10-15 JACOB MEDICAL ASSOCIATES LLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-08-01
Business code 621111
Sponsor’s telephone number 3219466864
Plan sponsor’s address 426 DISSTON AVENUE, CLERMONT, FL, 34711

Signature of
Role Plan administrator
Date 2020-10-15
Name of individual signing VIOLA JACOB
Valid signature Filed with authorized/valid electronic signature
JACOB MEDICAL ASSOCIATES LLC 401(K) PLAN 2019 680647865 2020-10-14 JACOB MEDICAL ASSOCIATES LLC 2
Three-digit plan number (PN) 001
Effective date of plan 2009-08-01
Business code 621111
Sponsor’s telephone number 3219466864
Plan sponsor’s address 426 DISSTON AVENUE, CLERMONT, FL, 34711

Signature of
Role Plan administrator
Date 2020-10-14
Name of individual signing VIOLA JACOB
Valid signature Filed with authorized/valid electronic signature
JACOB MEDICAL ASSOCIATES LLC 401(K) PLAN 2018 680647865 2019-07-31 JACOB MEDICAL ASSOCIATES LLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-08-01
Business code 621111
Sponsor’s telephone number 3219466864
Plan sponsor’s address 426 DISSTON AVENUE, CLERMONT, FL, 34711

Signature of
Role Plan administrator
Date 2019-07-31
Name of individual signing VIOLA JACOB
Valid signature Filed with authorized/valid electronic signature
JACOB MEDICAL ASSOCIATES LLC 401(K) PLAN 2017 680647865 2018-10-09 JACOB MEDICAL ASSOCIATES LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-08-01
Business code 621111
Sponsor’s telephone number 3219466864
Plan sponsor’s address 426 DISSTON AVENUE, CLERMONT, FL, 34711

Signature of
Role Plan administrator
Date 2018-10-09
Name of individual signing VIOLA JACOB
Valid signature Filed with authorized/valid electronic signature
JACOB MEDICAL ASSOCIATES LLC 401(K) PLAN 2016 680647865 2017-07-19 JACOB MEDICAL ASSOCIATES LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-08-01
Business code 621111
Sponsor’s telephone number 3219466864
Plan sponsor’s address 426 DISSTON AVENUE, CLERMONT, FL, 34711

Signature of
Role Plan administrator
Date 2017-07-19
Name of individual signing VIOLA JACOB
Valid signature Filed with authorized/valid electronic signature
JACOB MEDICAL ASSOCIATES LLC 401(K) PLAN 2015 680647865 2016-10-13 JACOB MEDICAL ASSOCIATES LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-08-01
Business code 621111
Sponsor’s telephone number 3219466864
Plan sponsor’s address 426 DISSTON AVENUE, CLERMONT, FL, 34711

Signature of
Role Plan administrator
Date 2016-10-13
Name of individual signing VIOLA JACOB
Valid signature Filed with authorized/valid electronic signature
JACOB MEDICAL ASSOCIATES LLC 401(K) PLAN 2014 680647865 2017-07-31 JACOB MEDICAL ASSOCIATES LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-08-01
Business code 621111
Sponsor’s telephone number 3219466864
Plan sponsor’s address 426 DISSTON AVENUE, CLERMONT, FL, 34711

Signature of
Role Plan administrator
Date 2017-07-31
Name of individual signing VIOLA JACOB
Valid signature Filed with authorized/valid electronic signature
JACOB MEDICAL ASSOCIATES LLC 401(K) PLAN 2013 680647865 2014-07-28 JACOB MEDICAL ASSOCIATES LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-08-01
Business code 621111
Sponsor’s telephone number 3219466864
Plan sponsor’s address 426 DISSTON AVENUE, CLERMONT, FL, 34711

Signature of
Role Plan administrator
Date 2014-07-28
Name of individual signing VIOLA JACOB
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
VIOLA, JACOB Agent 15725 willo pines lane, Montverde, FL 34756
JACOB, VIOLA M, Dr. Managing Member 15725 willo pines lane, Montverde, FL 34756

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2022-01-20 15725 willo pines lane, Montverde, FL 34756 -
CHANGE OF MAILING ADDRESS 2022-01-20 15725 willo pines lane, Montverde, FL 34756 -
REGISTERED AGENT ADDRESS CHANGED 2022-01-07 15725 willo pines lane, Montverde, FL 34756 -
REGISTERED AGENT NAME CHANGED 2010-01-17 VIOLA, JACOB -

Documents

Name Date
ANNUAL REPORT 2024-04-26
ANNUAL REPORT 2023-04-02
ANNUAL REPORT 2022-01-07
ANNUAL REPORT 2021-03-23
ANNUAL REPORT 2020-03-10
ANNUAL REPORT 2019-04-26
ANNUAL REPORT 2018-05-04
ANNUAL REPORT 2017-04-25
ANNUAL REPORT 2016-05-02
AMENDED ANNUAL REPORT 2015-02-08

USAspending Awards. Financial Assistance

FAIN Awarding Agency Assistance Listings Start Date End Date Description
2862345002 Small Business Administration 59.012 - 7(A) LOAN GUARANTEES - - TO AID SMALL BUSINESSES WHICH ARE UNABLE TO OBTAIN FINANCING IN THE PRIVATE CREDIT MARKETPLACE
Recipient JACOB MEDICAL ASSOCIATES, LLC
Recipient Name Raw JACOB MEDICAL ASSOCIATES, LLC
Recipient DUNS 055848050
Recipient Address 605 LAMAR AVENUE, BROOKSVILLE, HERNANDO, FLORIDA, 34601-0000, UNITED STATES
Obligated Amount 0.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page
2862295000 Small Business Administration 59.012 - 7(A) LOAN GUARANTEES - - TO AID SMALL BUSINESSES WHICH ARE UNABLE TO OBTAIN FINANCING IN THE PRIVATE CREDIT MARKETPLACE
Recipient JACOB MEDICAL ASSOCIATES, LLC
Recipient Name Raw JACOB MEDICAL ASSOCIATES, LLC
Recipient DUNS 055848050
Recipient Address 605 LAMAR AVENUE, BROOKSVILLE, HERNANDO, FLORIDA, 34601-0000, UNITED STATES
Obligated Amount 0.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 58500.00
Link View Page

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
3945218008 2020-06-25 0491 PPP 426 Disston Ave, CLERMONT, FL, 34711-2633
Loan Status Date 2021-02-17
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 21667.5
Loan Approval Amount (current) 21667.5
Undisbursed Amount 0
Franchise Name -
Lender Location ID 117723
Servicing Lender Name SouthState Bank, National Association
Servicing Lender Address 1101 First St South, WINTER HAVEN, FL, 33880-3908
Rural or Urban Indicator U
Hubzone N
LMI Y
Business Age Description Existing or more than 2 years old
Project Address CLERMONT, LAKE, FL, 34711-2633
Project Congressional District FL-11
Number of Employees 2
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Not Hispanic or Latino
Business Type Limited Liability Company(LLC)
Originating Lender ID 117723
Originating Lender Name SouthState Bank, National Association
Originating Lender Address WINTER HAVEN, FL
Gender Female Owned
Veteran Non-Veteran
Forgiveness Amount 21779.45
Forgiveness Paid Date 2021-01-07

Companies related by officers

No other companies in our directory share the same officers as JACOB MEDICAL ASSOCIATES, LLC

Companies related by address

No other companies in our directory share the same address as JACOB MEDICAL ASSOCIATES, LLC

Date of last update: 25 Feb 2025

Sources: Florida Department of State

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