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  5. BREVARD INTERNAL MEDICINE & WALK-IN CLINIC PLLC

BREVARD INTERNAL MEDICINE & WALK-IN CLINIC PLLC

Company Details

Entity Name: BREVARD INTERNAL MEDICINE & WALK-IN CLINIC PLLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Company
Status: Active
Date Filed: 08 Dec 2009 (15 years ago)
Document Number: L09000116805
FEI/EIN Number 27-1424884
Address: 2795 W. NEW HAVEN AVE., W. MELBOURNE, FL 32904
Mail Address: P O BOX 411685, MELBOURNE, FL 32941
ZIP code: 32904
County: Brevard
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1710216262 2009-12-11 2014-02-07 PO BOX 411685, MELBOURNE, FL, 329411685, US 2795 W NEW HAVEN AVE, W MELBOURNE, FL, 329043705, US

Contacts
Phone +1 321-622-8626
Fax 3216228627

Authorized person
Name DR. ARAVIND KUMAR
Role SOLE OWNER
Phone 3216228626

Taxonomy
Taxonomy Code 261QP2300X - Primary Care Clinic/Center
License Number ME97764
State FL
Is Primary Yes
Taxonomy Code 261QP2300X - Primary Care Clinic/Center
License Number ARNP 2107012
State FL
Is Primary No

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BREVARD INTERNAL MEDICINE & WALK-IN CLINIC PLLC PROFIT SHARING PLAN 2023 271424884 2024-10-13 BREVARD INTERNAL MEDICINE & WALK-IN CLINIC PLLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 3216228626
Plan sponsor’s address 2795 W NEW HAVEN AVE, WEST MELBOURNE, FL, 329043705

Signature of
Role Plan administrator
Date 2024-10-13
Name of individual signing MICHAEL GEMMELL
Valid signature Filed with authorized/valid electronic signature
BREVARD INTERNAL MEDICINE & WALK-IN CLINIC PLLC PROFIT SHARING PLAN 2022 271424884 2023-10-12 BREVARD INTERNAL MEDICINE & WALK-IN CLINIC PLLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 3216228626
Plan sponsor’s address 2795 W NEW HAVEN AVE, WEST MELBOURNE, FL, 329043705

Signature of
Role Plan administrator
Date 2023-10-12
Name of individual signing MICHAEL GEMMELL
Valid signature Filed with authorized/valid electronic signature
BREVARD INTERNAL MEDICINE & WALK-IN CLINIC PLLC PROFIT SHARING PLAN 2021 271424884 2022-10-14 BREVARD INTERNAL MEDICINE & WALK-IN CLINIC PLLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 3216228626
Plan sponsor’s address 2795 W NEW HAVEN AVE, WEST MELBOURNE, FL, 329043705

Signature of
Role Plan administrator
Date 2022-10-14
Name of individual signing MICHAEL GEMMELL
Valid signature Filed with authorized/valid electronic signature
BREVARD INTERNAL MEDICINE & WALK-IN CLINIC PLLC PROFIT SHARING PLAN 2020 271424884 2021-10-12 BREVARD INTERNAL MEDICINE & WALK-IN CLINIC PLLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 3216228626
Plan sponsor’s address 2795 W NEW HAVEN AVE, WEST MELBOURNE, FL, 329043705

Signature of
Role Plan administrator
Date 2021-10-12
Name of individual signing MICHAEL GEMMELL
Valid signature Filed with authorized/valid electronic signature
BREVARD INTERNAL MEDICINE & WALK-IN CLINIC PLLC PROFIT SHARING PLAN 2019 271424884 2020-10-08 BREVARD INTERNAL MEDICINE & WALK-IN CLINIC PLLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 3216228626
Plan sponsor’s address 2795 W NEW HAVEN AVE, MELBOURNE, FL, 329043705

Signature of
Role Plan administrator
Date 2020-10-08
Name of individual signing MICHAEL GEMMELL
Valid signature Filed with authorized/valid electronic signature
BREVARD INTERNAL MEDICINE & WALK-IN CLINIC PLLC PROFIT SHARING PLAN 2018 271424884 2019-08-22 BREVARD INTERNAL MEDICINE & WALK-IN CLINIC PLLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 3216228626
Plan sponsor’s address 2795 W NEW HAVEN AVE, MELBOURNE, FL, 329043705

Signature of
Role Plan administrator
Date 2019-08-18
Name of individual signing MICHAEL GEMMELL
Valid signature Filed with authorized/valid electronic signature
BREVARD INTERNAL MEDICINE & WALK-IN CLINIC PLLC PROFIT SHARING PLAN 2017 271424884 2018-07-28 BREVARD INTERNAL MEDICINE & WALK-IN CLINIC PLLC 3
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 3216228626
Plan sponsor’s address 2795 W NEW HAVEN AVE, MELBOURNE, FL, 329043705

Signature of
Role Plan administrator
Date 2018-07-22
Name of individual signing MICHAEL GEMMELL
Valid signature Filed with authorized/valid electronic signature
BREVARD INTERNAL MEDICINE & WALK-IN CLINIC PLLC PROFIT SHARING PLAN 2016 271424884 2017-07-26 BREVARD INTERNAL MEDICINE & WALK-IN CLINIC PLLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 3216228626
Plan sponsor’s address 2795 W NEW HAVEN AVE, MELBOURNE, FL, 329043705

Signature of
Role Plan administrator
Date 2017-07-22
Name of individual signing MICHAEL GEMMELL
Valid signature Filed with authorized/valid electronic signature
BREVARD INTERNAL MEDICINE & WALK-IN CLINIC PLLC PROFIT SHARING PLAN 2014 271424884 2015-07-26 BREVARD INTERNAL MEDICINE & WALK-IN CLINIC PLLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 3216228626
Plan sponsor’s address 2795 W NEW HAVEN AVENUE, MELBOURNE, FL, 32904

Signature of
Role Plan administrator
Date 2015-07-26
Name of individual signing MICHAEL GEMMELL
Valid signature Filed with authorized/valid electronic signature
BREVARD INTERNAL MEDICINE & WALK-IN CLINIC PLLC PROFIT SHARING PLAN 2013 271424884 2014-07-30 BREVARD INTERNAL MEDICINE & WALK-IN CLINIC PLLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 3216228626
Plan sponsor’s address 2795 W NEW HAVEN AVE, MELBOURNE, FL, 32904

Signature of
Role Plan administrator
Date 2014-07-30
Name of individual signing MICHAEL GEMMELL
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
KUMAR, ARAVIND Agent 3457 CAPPIO DRIVE, MELBOURNE, FL 32940

Managing Member

Name Role Address
KUMAR, ARAVIND Managing Member 3457 CAPPIO DRIVE, MELBOURNE, FL 32940

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2013-04-07 2795 W. NEW HAVEN AVE., W. MELBOURNE, FL 32904 No data
CHANGE OF MAILING ADDRESS 2010-01-05 2795 W. NEW HAVEN AVE., W. MELBOURNE, FL 32904 No data

Court Cases

Title Case Number Docket Date Status
SRINIVAS RAO DONTINENI, M.D. VS PATRICIA SANDERSON, JOSEPH BOULAY, M.D., ALL STAR RECRUITING LOCUMS, LLC, ANGELO FERNANDES, M.D., ARVIND KUMAR, M.D., BREVARD INTERNAL MEDICINE & WALK IN CLINIC, PLLC, ET AL. 5D2021-2956 2021-12-02 Closed
Classification Original Proceedings - Circuit Civil - Certiorari
Court 5th District Court of Appeal
Originating Court Circuit Court for the Eighteenth Judicial Circuit, Brevard County
05-2019-CA-035380

Parties
Name Srinivas Rao Dontineni, M.D.
Role Petitioner
Status Active
Representations Julie Brodis, Christian P. Trowbridge, Craig S. Foels
Name Aravind Kumar, M.D.
Role Respondent
Status Active
Name Patricia Sanderson
Role Respondent
Status Active
Representations Andrew S. Bolin, Spencer L. Payne, Deborah Lynn Moskowitz, Matthew E. Lewis, Brian J. Lee
Name Angelo Fernendes, M.D.
Role Respondent
Status Active
Name ALL STAR RECRUITING LOCUMS, LLC
Role Respondent
Status Active
Name BREVARD INTERNAL MEDICINE & WALK-IN CLINIC PLLC
Role Respondent
Status Active
Name HOLMES REGIONAL MEDICAL CENTER, INC.
Role Respondent
Status Active
Name Joseph Boulay, M.D.
Role Respondent
Status Active
Name Hon. W. David Dugan
Role Judge/Judicial Officer
Status Active
Name Clerk Brevard
Role Lower Tribunal Clerk
Status Active

Docket Entries
Docket Date 2022-07-25
Type Record
Subtype Returned Records
Description Returned Records ~ NO RECORD E-FILED
Docket Date 2022-07-25
Type Mandate
Subtype Mandate
Description Mandate
Docket Date 2022-07-01
Type Disposition by Opinion
Subtype Granted
Description Granted - Per Curiam Opinion ~ ORDER QUASHED AND REMANDED FOR FURTHER PROCEEDINGS
Docket Date 2022-02-03
Type Response
Subtype Reply
Description REPLY
On Behalf Of Srinivas Rao Dontineni, M.D.
Docket Date 2022-01-24
Type Response
Subtype Response
Description RESPONSE ~ PER 12/3 ORDER
On Behalf Of Patricia Sanderson
Docket Date 2021-12-15
Type Order
Subtype Order on Motion for Extension of Time to File Response
Description Order Grant EOT to file Response to Ct. Order ~ RS PATRICIA SANDERSON'S RESPONSE BY 1/24/22
Docket Date 2021-12-14
Type Motions Extensions
Subtype Motion for Extension of Time to File Response
Description Motion for Extension of Time to File Response
On Behalf Of Patricia Sanderson
Docket Date 2021-12-03
Type Order
Subtype Order to File Response
Description ORD-Respondent to Respond ~ RESPONSE W/IN 20 DYS; REPLY W/IN 10 DYS
Docket Date 2021-12-03
Type Notice
Subtype Notice of Appearance
Description Notice of Appearance
On Behalf Of Patricia Sanderson
Docket Date 2021-12-02
Type Misc. Events
Subtype Fee Status
Description FP:Fee Paid Through Portal
Docket Date 2021-12-02
Type Record
Subtype Appendix to Petition
Description Appendix to Petition
On Behalf Of Srinivas Rao Dontineni, M.D.
Docket Date 2021-12-02
Type Petition
Subtype Petition
Description Petition Filed ~ FILED 12/2/21
On Behalf Of Srinivas Rao Dontineni, M.D.
Docket Date 2021-12-02
Type Letter
Subtype Acknowledgment Letter
Description Acknowledgement Letter 1

Documents

Name Date
ANNUAL REPORT 2024-05-01
ANNUAL REPORT 2023-04-30
ANNUAL REPORT 2022-04-30
ANNUAL REPORT 2021-04-30
ANNUAL REPORT 2020-06-28
ANNUAL REPORT 2019-04-14
ANNUAL REPORT 2018-04-26
ANNUAL REPORT 2017-04-16
ANNUAL REPORT 2016-04-11
ANNUAL REPORT 2015-03-22

Related by officers

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Related by address

No related companies by address

Date of last update: 25 Jan 2025

Sources: Florida Department of State

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