| Entity Name: | CHAPPEL FAMILY PRACTICE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 17 Nov 2008 (16 years ago) |
| Date of dissolution: | 25 Sep 2015 (9 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2015 (9 years ago) |
| Document Number: | L08000106762 |
| FEI/EIN Number | 263724249 |
| Address: | 222 BROADWAY, SUITE 301, KISSIMMEE, FL, 34741, US |
| Mail Address: | 222 BROADWAY, SUITE 301, KISSIMMEE, FL, 34741, US |
| ZIP code: | 34741 |
| County: | Osceola |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1306031554 | 2007-09-11 | 2018-06-20 | 222 BROADWAY, SUITE 302, KISSIMMEE, FL, 34741, US | 222 BROADWAY, SUITE 302, KISSIMMEE, FL, 34741, US | |||||||||||||||||||||||||
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| Phone | +1 407-846-8180 |
| Fax | 4073474858 |
Authorized person
| Name | MS. JAIME DANIELS |
| Role | CEO |
| Phone | 4078468180 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ME36463 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 002495300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CHAPPEL CHRISTOPHER MDr. | Agent | 222 BROADWAY, KISSIMMEE, FL, 34741 |
| Name | Role | Address |
|---|---|---|
| CHAPPEL CHRISTOPHER MDr. | Managing Member | 222 BROADWAY SUITE 302, KISSIMMEE, FL, 34741 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2013-04-01 | 222 BROADWAY, SUITE 301, KISSIMMEE, FL 34741 | No data |
| REGISTERED AGENT NAME CHANGED | 2013-04-01 | CHAPPEL, CHRISTOPHER M, Dr. | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-04-11 | 222 BROADWAY, SUITE 301, KISSIMMEE, FL 34741 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-04-11 | 222 BROADWAY, SUITE 302, KISSIMMEE, FL 34741 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2014-04-29 |
| ANNUAL REPORT | 2013-04-01 |
| ANNUAL REPORT | 2012-09-26 |
| ANNUAL REPORT | 2012-04-11 |
| ANNUAL REPORT | 2011-04-22 |
| ANNUAL REPORT | 2010-04-20 |
| ANNUAL REPORT | 2009-04-14 |
| Florida Limited Liability | 2008-11-17 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
