| Entity Name: | FATIMA MEDICAL GROUP LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 01 Mar 2011 (14 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 16 Nov 2018 (6 years ago) |
| Document Number: | L11000025153 |
| FEI/EIN Number | 275276950 |
| Address: | 4824 10th Ave N, Greenacres, FL, 33463, US |
| Mail Address: | 8465 Vaulting Dr, Lake Worth, FL, 33467, US |
| ZIP code: | 33463 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1972896116 | 2011-05-20 | 2011-05-20 | 1800 FOREST HILL BLVD, # B-9, WEST PALM BEACH, FL, 334066094, US | 1800 FOREST HILL BLVD, # B-9, WEST PALM BEACH, FL, 334066094, US | |||||||||||||||||||
|
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| Phone | +1 561-968-2913 |
| Fax | 5619682920 |
Authorized person
| Name | JEAN-LUC MICHEL |
| Role | OWNER/PRESIDENT |
| Phone | 5619682913 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ACN96 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MICHEL IMMACULA M | Agent | 4824 10th Ave N, Greenacres, FL, 33463 |
| Name | Role | Address |
|---|---|---|
| MICHEL IMMACULA M.D. | Manager | 4824 10th Ave N, Greenacres, FL, 33463 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000076724 | UNLIMITED MOBILE EMC SERVICE | EXPIRED | 2019-07-15 | 2024-12-31 | No data | 8130 NW 20TH CT, SUNRISE, FL, 33322 |
| G17000006928 | FATIMA MEDICAL AND REHABILITATION CENTER | EXPIRED | 2017-01-19 | 2022-12-31 | No data | 990 SOUTH CONGRESS AVE, FORT LAUDERDALE, FL, 33319 |
| G16000076395 | FATIMA MEDICAL RESEARCH | EXPIRED | 2016-07-30 | 2021-12-31 | No data | 1800 FOREST HILL BLVD, STE B-9, WEST PALM BEACH, FL, 33406 |
| G11000037006 | FATIMA MEDICAL CENTER | EXPIRED | 2011-04-15 | 2016-12-31 | No data | 1800 FOREST HILL BLVD., SUITE B-9, WEST PALM BEACH, FL, 33406 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-01-24 | 4824 10th Ave N, Greenacres, FL 33463 | No data |
| CHANGE OF MAILING ADDRESS | 2024-01-24 | 4824 10th Ave N, Greenacres, FL 33463 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-01-24 | 4824 10th Ave N, Greenacres, FL 33463 | No data |
| LC AMENDMENT | 2018-11-16 | No data | No data |
| LC AMENDMENT | 2013-09-27 | No data | No data |
| LC AMENDMENT | 2011-09-12 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J20000185989 | ACTIVE | 50-2019-CC-000601-XXXX-MB | PALM BEACH COUNTY COURT | 2019-05-13 | 2025-03-27 | $6,966.78 | GREER LABORATORIES INC., 639 NUWAY CIRCLE, LENOIR, NC 28645 |
| J17000474926 | TERMINATED | 1000000752616 | PALM BEACH | 2017-08-02 | 2027-08-16 | $ 1,272.67 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, WEST PALM BEACH SERVICE CENTER, 2468 METROCENTRE BLVD, WEST PALM BEACH FL334073105 |
| J16000393037 | TERMINATED | 1000000714355 | PALM BEACH | 2016-06-01 | 2026-06-22 | $ 620.95 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, WEST PALM BEACH SERVICE CENTER, 2468 METROCENTRE BLVD, WEST PALM BEACH FL334073105 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-24 |
| ANNUAL REPORT | 2023-01-25 |
| AMENDED ANNUAL REPORT | 2022-12-16 |
| AMENDED ANNUAL REPORT | 2022-10-12 |
| ANNUAL REPORT | 2022-01-24 |
| ANNUAL REPORT | 2021-01-11 |
| ANNUAL REPORT | 2020-03-02 |
| ANNUAL REPORT | 2019-04-24 |
| LC Amendment | 2018-11-16 |
| ANNUAL REPORT | 2018-03-25 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
