| Entity Name: | STUART INTERNAL MEDICINE GROUP, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 20 Nov 2007 (17 years ago) |
| Date of dissolution: | 28 Sep 2012 (12 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2012 (12 years ago) |
| Document Number: | L07000116999 |
| FEI/EIN Number | 261481868 |
| Mail Address: | 875 MILITARY TRAIL, SUITE 200, JUPITER, FL, 33458, US |
| Address: | 19 SE OSCEOLA STREET, STUART, FL, 34994, US |
| ZIP code: | 34994 |
| County: | Martin |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1972764223 | 2008-06-19 | 2008-06-19 | 19 SE OSCEOLA ST, STUART, FL, 349942125, US | 19 SE OSCEOLA ST, STUART, FL, 349942125, US | |||||||||||||||||||||||||||||
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| Phone | +1 772-283-4093 |
| Fax | 7722839874 |
Authorized person
| Name | RAJENDRA K. BANSAL |
| Role | MEDICAL DIRECTOR |
| Phone | 7722834093 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 207RR0500X - Rheumatology Physician |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| BANSAL RAJENDRA | Agent | 875 MILITARY TRAIL, JUPITER, FL, 33458 |
| Name | Role | Address |
|---|---|---|
| BANSAL RAJENDRA K | Managing Member | 875 MILITARY TRAIL, STE 200, JUPITER, FL, 33458 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2009-01-16 | 19 SE OSCEOLA STREET, STUART, FL 34994 | No data |
| REGISTERED AGENT NAME CHANGED | 2008-03-13 | BANSAL, RAJENDRA | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2008-03-13 | 875 MILITARY TRAIL, SUITE 200, JUPITER, FL 33458 | No data |
| LC AMENDMENT AND NAME CHANGE | 2007-12-10 | STUART INTERNAL MEDICINE GROUP, LLC | No data |
| LC NAME CHANGE | 2007-12-04 | STUART INTERNAL MEDICINE, LLC | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2011-01-17 |
| ANNUAL REPORT | 2010-02-16 |
| ANNUAL REPORT | 2009-01-16 |
| ANNUAL REPORT | 2008-03-13 |
| LC Amendment and Name Change | 2007-12-10 |
| LC Name Change | 2007-12-04 |
| Florida Limited Liability | 2007-11-20 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
