| Entity Name: | TUI FAMILY MEDICINE PL |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 06 Oct 2010 (14 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 03 Sep 2015 (9 years ago) |
| Document Number: | L10000104409 |
| FEI/EIN Number | 273657146 |
| Address: | 4554 CLYDE MORRIS BLVD, SUITE 2, PORT ORANGE, FL, 32129, US |
| Mail Address: | P.O. BOX 290035, PORT ORANGE, FL, 32129, US |
| ZIP code: | 32129 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1386940013 | 2011-01-27 | 2011-10-12 | PO BOX 290035, PORT ORANGE, FL, 321290035, US | 4554 S CLYDE MORRIS BLVD, SUITE 2, PORT ORANGE, FL, 321295403, US | |||||||||||||||||
|
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| Phone | +1 386-304-2990 |
Authorized person
| Name | ANUNPORN SRISAWAT |
| Role | MANAGING MEMBER |
| Phone | 3863042990 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| License Number | ME 95967 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SRISAWAT ANUNPORN | Agent | 3817 CALLIOPE AVE, PORT ORANGE, FL, 32129 |
| Name | Role | Address |
|---|---|---|
| SRISAWAT ANUNPORN | Managing Member | 3817 CALLIOPE AVE, PORT ORANGE, FL, 32129 |
| Name | Role | Address |
|---|---|---|
| Srisawat Suid W | Member | 3817 Calliope Ave, Port Orange, FL, 32129 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2015-09-03 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2012-02-14 | SRISAWAT, ANUNPORN | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-02-14 | 3817 CALLIOPE AVE, PORT ORANGE, FL 32129 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-02-28 | 4554 CLYDE MORRIS BLVD, SUITE 2, PORT ORANGE, FL 32129 | No data |
| CHANGE OF MAILING ADDRESS | 2011-02-28 | 4554 CLYDE MORRIS BLVD, SUITE 2, PORT ORANGE, FL 32129 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-09 |
| ANNUAL REPORT | 2023-02-13 |
| ANNUAL REPORT | 2022-02-28 |
| ANNUAL REPORT | 2021-02-13 |
| ANNUAL REPORT | 2020-03-21 |
| ANNUAL REPORT | 2019-04-03 |
| ANNUAL REPORT | 2018-03-05 |
| ANNUAL REPORT | 2017-03-04 |
| ANNUAL REPORT | 2016-02-17 |
| LC Amendment | 2015-09-03 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
