| Entity Name: | FAWAZ MEDICAL AND SURGICAL CLINIC, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
FAWAZ MEDICAL AND SURGICAL CLINIC, 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. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 29 Sep 2011 (13 years ago) |
| Document Number: | L11000112037 |
| FEI/EIN Number |
453780140
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 962 HWY, 331 SOUTH, DEFUNIAK SPRINGS, FL, 32435 |
| Mail Address: | 962 HWY, 331 SOUTH, DEFUNIAK SPRINGS, FL, 32435 |
| ZIP code: | 32435 |
| County: | Walton |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1801207626 | 2014-05-14 | 2014-05-14 | 962 US HIGHWAY 331 S, DEFUNIAK SPRINGS, FL, 324353372, US | 962 US HIGHWAY 331 S, DEFUNIAK SPRINGS, FL, 324353372, US | |||||||||||||||||
|
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| Phone | +1 850-951-8800 |
Authorized person
| Name | JANNA MAULDIN |
| Role | OFFICE MANAGER |
| Phone | 8509518800 |
Taxonomy
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| License Number | ME82523 |
| State | ZZ |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FAWAZ FAWZI | Authorized Member | 598 S.SECOND STREET, DEFUNIAK SPRINGS, FL, 32435 |
| DISNEY MARY C | Agent | 1184 CIRCLE DR STE A, DEFUNIAK SPRINGS, FL, 32435 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2017-04-28 | DISNEY, MARY CATHERINE | - |
| REGISTERED AGENT ADDRESS CHANGED | 2017-04-28 | 1184 CIRCLE DR STE A, DEFUNIAK SPRINGS, FL 32435 | - |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J13001244152 | TERMINATED | 1000000518411 | WALTON | 2013-07-30 | 2023-08-07 | $ 1,397.06 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, OUT OF STATE COLLECTIONS UNIT, 1401 W US HIGHWAY 90 STE 100, LAKE CITY FL320556123 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-28 |
| ANNUAL REPORT | 2023-04-25 |
| ANNUAL REPORT | 2022-04-26 |
| ANNUAL REPORT | 2021-03-31 |
| ANNUAL REPORT | 2020-04-28 |
| ANNUAL REPORT | 2019-04-16 |
| ANNUAL REPORT | 2018-04-30 |
| ANNUAL REPORT | 2017-04-28 |
| ANNUAL REPORT | 2016-04-25 |
| ANNUAL REPORT | 2015-04-29 |
Date of last update: 02 Mar 2025
Sources: Florida Department of State
