| Entity Name: | MERRITT ISLAND WALK-IN CLINIC, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 21 Jan 2010 (15 years ago) |
| Date of dissolution: | 02 Aug 2024 (6 months ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 02 Aug 2024 (6 months ago) |
| Document Number: | L10000007768 |
| FEI/EIN Number | 271723464 |
| Address: | 1045 NORTH COURTENAY PARKWAY, MERRITT ISLAND, FL, 32953 |
| Mail Address: | 1045 NORTH COURTENAY PARKWAY, MERRITT ISLAND, FL, 32953 |
| ZIP code: | 32953 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1326451725 | 2014-06-04 | 2014-06-04 | 5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA, 921211705, US | 1045 N COURTENAY PKWY, MERRITT ISLAND, FL, 329534531, US | |||||||||||||||||
|
|||||||||||||||||||||
| Phone | +1 321-452-9255 |
Authorized person
| Name | KENNY HEINE |
| Role | VP OF OPERATIONS |
| Phone | 8589641506 |
Taxonomy
| Taxonomy Code | 332900000X - Non-Pharmacy Dispensing Site |
| License Number | ME95111 |
| State | FL |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MERRITT ISLAND WALK IN CLINIC 401 K PROFIT SHARING PLAN TRUST | 2018 | 271723464 | 2019-07-26 | MERRITT ISLAND WALK IN CLINIC | 1 | |||||||||||||||||||||||
|
||||||||||||||||||||||||||||
| Role | Plan administrator |
| Date | 2019-07-26 |
| Name of individual signing | JENNY PAGE |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2013-01-01 |
| Business code | 621498 |
| Sponsor’s telephone number | 3214533937 |
| Plan sponsor’s address | 1045 N COURTENAY PKWY, MERRITT ISLAND, FL, 32953 |
Signature of
| Role | Plan administrator |
| Date | 2017-06-14 |
| Name of individual signing | MIKE SPAHR |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2013-01-01 |
| Business code | 621498 |
| Sponsor’s telephone number | 3214533937 |
| Plan sponsor’s address | 1045 NORTH COURTENAY PKWY, MERRITT ISLAND, FL, 32953 |
Signature of
| Role | Plan administrator |
| Date | 2015-06-04 |
| Name of individual signing | RICK HARRIS |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2013-01-01 |
| Business code | 621498 |
| Sponsor’s telephone number | 3214533937 |
| Plan sponsor’s address | 1045 NORTH COURTENAY PKWY, MELBOURNE, FL, 32935 |
Signature of
| Role | Plan administrator |
| Date | 2014-07-17 |
| Name of individual signing | RICK HARRIS |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| PAUL RAJEE M | Agent | 1045 NORTH COURTENAY PARKWAY, MERRITT ISLAND, FL, 32953 |
| Name | Role | Address |
|---|---|---|
| PAUL RAJEE Dr. | Manager | 1045 NORTH COURTENAY PARKWAY, MERRITT ISLAND, FL, 32953 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000132852 | MERRITT ISLAND FAMILY PRACTICE | EXPIRED | 2018-12-17 | 2023-12-31 | No data | 1045 N. COURTENAY PKWY, MERRITT ISLAND, FL, 32953 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2024-08-02 | No data | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2024-08-02 |
| ANNUAL REPORT | 2024-04-26 |
| ANNUAL REPORT | 2023-04-26 |
| ANNUAL REPORT | 2022-09-21 |
| ANNUAL REPORT | 2021-03-15 |
| ANNUAL REPORT | 2020-04-30 |
| ANNUAL REPORT | 2019-02-06 |
| ANNUAL REPORT | 2018-01-15 |
| ANNUAL REPORT | 2017-01-10 |
| ANNUAL REPORT | 2016-02-03 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
