| Entity Name: | CHOICE ONE MEDICAL GROUP, L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 05 May 2010 (15 years ago) |
| Date of dissolution: | 22 Sep 2017 (7 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2017 (7 years ago) |
| Document Number: | L10000048588 |
| FEI/EIN Number | 272530185 |
| Address: | 49 N Federal Hwy, Pompano Beach, FL, 33062, US |
| Mail Address: | 49 N FEDERAL HWY #135, POMPANO BEACH, FL, 33062, US |
| ZIP code: | 33062 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508172206 | 2010-08-19 | 2015-02-25 | 49 N FEDERAL HWY, STE 350, POMPANO BEACH, FL, 330624304, US | 511 NE 3RD AVE, FORT LAUDERDALE, FL, 333013235, US | |||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||
| Phone | +1 954-703-6065 |
| Fax | 5618283372 |
| Phone | +1 954-903-0468 |
Authorized person
| Name | MARY C MARTINEZ |
| Role | VP OPERATIONS & NETWORK MNGT |
| Phone | 9547036065 |
Taxonomy
| Taxonomy Code | 171W00000X - Contractor |
| Is Primary | Yes |
| Taxonomy Code | 261QH0100X - Health Service Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 302F00000X - Exclusive Provider Organization |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| KRUGER ALLAN | Agent | 7451 WILES RD, CORAL SPRINGS, FL, 33067 |
| Name | Role | Address |
|---|---|---|
| BODGAN MICHAEL | Managing Member | 49 N FEDERAL HWY #135, POMPANO BEACH, FL, 33062 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-03-22 | 49 N Federal Hwy, 135, Pompano Beach, FL 33062 | No data |
| REGISTERED AGENT NAME CHANGED | 2015-11-06 | KRUGER, ALLAN | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-11-06 | 7451 WILES RD, 204, CORAL SPRINGS, FL 33067 | No data |
| CHANGE OF MAILING ADDRESS | 2015-01-05 | 49 N Federal Hwy, 135, Pompano Beach, FL 33062 | No data |
| LC AMENDMENT | 2014-09-12 | No data | No data |
| LC AMENDMENT | 2014-06-24 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2016-03-22 |
| AMENDED ANNUAL REPORT | 2015-11-06 |
| AMENDED ANNUAL REPORT | 2015-11-03 |
| ANNUAL REPORT | 2015-04-15 |
| LC Amendment | 2014-09-12 |
| LC Amendment | 2014-06-24 |
| ANNUAL REPORT | 2014-04-08 |
| ANNUAL REPORT | 2013-04-12 |
| ANNUAL REPORT | 2012-03-26 |
| ANNUAL REPORT | 2011-03-16 |
Date of last update: 03 Jan 2025
Sources: Florida Department of State
