FAMILY PRACTICE, DR. ASSEFA, LLC - Florida Company Profile

Company Details

Entity Name:	FAMILY PRACTICE, DR. ASSEFA, LLC
Jurisdiction:	FLORIDA
Filing Type:	Florida Limited Liability Co. FAMILY PRACTICE, DR. ASSEFA, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act
Status:	Inactive The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders.
Date Filed:	24 Jan 2011 (14 years ago)
Date of dissolution:	28 Feb 2022 (3 years ago)
Last Event:	VOLUNTARY DISSOLUTION
Event Date Filed:	28 Feb 2022 (3 years ago)
Document Number:	L11000009358
FEI/EIN Number	274981290 Federal Employer Identification (FEI) Number assigned by the IRS.
Address:	6100 ST. JOHNS AVENUE, SUITE 4, PALATKA, FL, 32177, US
Mail Address:	P.O. BOX 2627, PALATKA, FL, 32178, US
ZIP code:	32177
County:	Putnam
Place of Formation:	FLORIDA

NPI

Enumeration Date

Last Update Date

Mailing Address

Practice Location Address

1083913842

2011-03-19

2012-06-26

PO BOX 2627, PALATKA, FL, 321782627, US

6100 SAINT JOHNS AVE STE 4, PALATKA, FL, 321776859, US

Contacts

Phone	+1 386-329-3939
Fax	3863298990

Authorized person

Taxonomy

Taxonomy Code	261QP2300X - Primary Care Clinic/Center
License Number	ME67444
State	FL
Is Primary	Yes

Name	Role	Address
PACANOWSKA-ASSEFA IRENA M	Managing Member	6100 ST. JOHNS AVENUE, SUITE 4, PALATKA, FL, 32177
Assefa Girma Dr.	Manager	P.O. BOX 1426, PALATKA, FL, 32178
MOULTON CLAUDE R	Agent	1354 N. LAURA STREET, JACKSONVILLE, FL, 32206

Event Type	Filed Date	Value	Description
VOLUNTARY DISSOLUTION	2022-02-28	-	-
CHANGE OF MAILING ADDRESS	2019-02-05	6100 ST. JOHNS AVENUE, SUITE 4, PALATKA, FL 32177	-

Document Number	Status	Case Number	Name of Court	Date of Entry	Expiration Date	Amount Due	Plaintiff
J14001178747	LAPSED	1000000645175	PALM BEACH	2014-10-29	2024-12-17	$ 1,911.27	STATE OF FLORIDA, DEPARTMENT OF REVENUE, WEST PALM BEACH SERVICE CENTER, 2468 METROCENTRE BLVD, WEST PALM BEACH FL334073105
J14000736289	ACTIVE	1000000626483	PALM BEACH	2014-05-21	2034-06-17	$ 895.95	STATE OF FLORIDA, DEPARTMENT OF REVENUE, OUT OF STATE COLLECTIONS UNIT, 1401 W US HIGHWAY 90 STE 100, LAKE CITY FL320556123
J14000836881	ACTIVE	1000000611322	PALM BEACH	2014-04-30	2034-08-01	$ 925.36	STATE OF FLORIDA, DEPARTMENT OF REVENUE, OUT OF STATE COLLECTIONS UNIT, 1401 W US HIGHWAY 90 STE 100, LAKE CITY FL320556123
J14000302074	ACTIVE	1000000585120	PALM BEACH	2014-03-05	2034-03-13	$ 802.69	STATE OF FLORIDA, DEPARTMENT OF REVENUE, OUT OF STATE COLLECTIONS UNIT, 1401 W US HIGHWAY 90 STE 100
J14000299114	ACTIVE	1000000581551	PALM BEACH	2014-02-19	2034-03-13	$ 790.33	STATE OF FLORIDA, DEPARTMENT OF REVENUE, OUT OF STATE COLLECTIONS UNIT, 1401 W US HIGHWAY 90 STE 100
J13000945015	ACTIVE	1000000482775	PALM BEACH	2013-04-17	2033-05-22	$ 876.55	STATE OF FLORIDA, DEPARTMENT OF REVENUE, OUT OF STATE COLLECTIONS UNIT, 1401 W US HIGHWAY 90 STE 100, LAKE CITY FL320556123

Date of last update: 03 Apr 2025