| Entity Name: | PANAMA CITY PULMONARY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 08 Dec 2009 (15 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 10 Dec 2009 (15 years ago) |
| Document Number: | L09000116952 |
| FEI/EIN Number | 271455371 |
| Address: | 2426 JENKS AVE., PANAMA CITY, FL, 32405 |
| Mail Address: | P.O. Box 28449, PANAMA CITY BEACH, FL, 32411, US |
| ZIP code: | 32405 |
| County: | Bay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1689998940 | 2010-03-16 | 2018-11-05 | 1005 MAR WALT DR, FORT WALTON BEACH, FL, 325476707, US | 1005 MAR WALT DRIVE, PULMONOLOGY DEPARTMENT, FORT WALTON BEACH, FL, 325476707, US | |||||||||||||||||||||||||||||
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| Phone | +1 850-243-0118 |
| Fax | 8502430594 |
Authorized person
| Name | DR. ANGEL ARTURO NUNEZ |
| Role | PHYSICIAN |
| Phone | 8502430118 |
Taxonomy
| Taxonomy Code | 207RC0200X - Critical Care Medicine (Internal Medicine) Physician |
| Is Primary | No |
| Taxonomy Code | 207RP1001X - Pulmonary Disease Physician |
| Is Primary | Yes |
| Taxonomy Code | 207RS0012X - Sleep Medicine (Internal Medicine) Physician |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 259704700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Nunez Angel ADr. | Agent | 2426 JENKS AVE., PANAMA CITY, FL, 32405 |
| Name | Role | Address |
|---|---|---|
| NUNEZ ANGEL D | Managing Member | 2426 JENKS AVE., PANAMA CITY, FL, 02405 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2019-05-01 | 2426 JENKS AVE., PANAMA CITY, FL 32405 | No data |
| REGISTERED AGENT NAME CHANGED | 2016-04-30 | Nunez, Angel A, Dr. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-04-30 | 2426 JENKS AVE., PANAMA CITY, FL 32405 | No data |
| LC AMENDMENT | 2009-12-10 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-12-10 | 2426 JENKS AVE., PANAMA CITY, FL 32405 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-05-04 |
| ANNUAL REPORT | 2023-04-30 |
| ANNUAL REPORT | 2022-04-30 |
| ANNUAL REPORT | 2021-09-15 |
| ANNUAL REPORT | 2020-06-10 |
| ANNUAL REPORT | 2019-05-01 |
| ANNUAL REPORT | 2018-05-08 |
| ANNUAL REPORT | 2017-04-30 |
| ANNUAL REPORT | 2016-04-30 |
| ANNUAL REPORT | 2015-03-04 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
