| Entity Name: | CENTURY CLINICAL FAMILY MEDICINE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 22 Sep 2009 (15 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 27 Sep 2017 (7 years ago) |
| Document Number: | L09000091667 |
| FEI/EIN Number | 270973519 |
| Address: | 1410 LPGA BLVD, 136, DAYTONA BEACH, FL, 32117 |
| Mail Address: | 1410 LPGA BLVD, 136, DAYTONA BEACH, FL, 32117 |
| ZIP code: | 32117 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1306247093 | 2014-09-12 | 2014-09-12 | 1410 LPGA BLVD, DAYTONA BEACH, FL, 321175115, US | 1410 LPGA BLVD, DAYTONA BEACH, FL, 321175115, US | |||||||||||||||||
|
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| Phone | +1 386-274-4750 |
Authorized person
| Name | LORAY ANTOINETTE BLAIR-BRITT |
| Role | FAMILY PHYSICIAN |
| Phone | 3866151595 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ME60233 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GASKIN THOMAS L | Agent | 108 PLEASANT VALLEY DRIVE, DAYTONA BEACH, FL, 32114 |
| Name | Role | Address |
|---|---|---|
| GASKIN THOMAS L | Managing Member | 108 PLEASANT VALLEY DRIVE, DAYTONA BEACH, FL, 32114 |
| Name | Role | Address |
|---|---|---|
| GASKIN TINA G | Manager | 108 PLEASANT VALLEY DRIVE, DAYTONA BEACH, FL, 32114 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G10000014160 | CENTURY CLINICAL | EXPIRED | 2010-02-12 | 2015-12-31 | No data | 1410 LPGA BLVD, STE 132, DAYTONA BEACH, FL, 32117 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2017-09-27 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2017-09-27 | GASKIN, THOMAS LJR | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-03-19 | 1410 LPGA BLVD, 136, DAYTONA BEACH, FL 32117 | No data |
| CHANGE OF MAILING ADDRESS | 2010-03-19 | 1410 LPGA BLVD, 136, DAYTONA BEACH, FL 32117 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-07 |
| ANNUAL REPORT | 2023-07-11 |
| ANNUAL REPORT | 2022-04-11 |
| ANNUAL REPORT | 2021-04-08 |
| ANNUAL REPORT | 2020-04-08 |
| ANNUAL REPORT | 2019-06-17 |
| ANNUAL REPORT | 2018-03-16 |
| REINSTATEMENT | 2017-09-27 |
| ANNUAL REPORT | 2016-05-10 |
| ANNUAL REPORT | 2015-06-09 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
