| Entity Name: | MANAGED HEALTHCARE MEDICAL GROUP, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 22 Nov 2011 (13 years ago) |
| Document Number: | L11000132608 |
| FEI/EIN Number | 454366616 |
| Address: | 150 S. Pine Island Road, PLANTATION, FL, 33324, US |
| Mail Address: | 150 S. Pine Island Road, PLANTATION, FL, 33324, US |
| ZIP code: | 33324 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1255032025 | 2023-03-16 | 2023-03-16 | 150 S PINE ISLAND RD STE 300, PLANTATION, FL, 333242665, US | 150 S PINE ISLAND RD STE 300, PLANTATION, FL, 333242665, US | |||||||||||||||
|
|||||||||||||||||||
| Phone | +1 754-224-9333 |
| Fax | 9543378265 |
Authorized person
| Name | LUCINDA BLUNT |
| Role | CEO |
| Phone | 7542249333 |
Taxonomy
| Taxonomy Code | 302F00000X - Exclusive Provider Organization |
| Is Primary | Yes |
| Name | Role |
|---|---|
| INDIBLU MANAGEMENT, LLC | Agent |
| Name | Role | Address |
|---|---|---|
| BLUNT LUCINDA E | Managing Member | 150 S. Pine Island Road, PLANTATION, FL, 33324 |
| BLUNT-PASCAL CHERISE N | Managing Member | 150 S. Pine Island Road, PLANTATION, FL, 33324 |
| BLUNT III WILLIAM H | Managing Member | 150 S. Pine Island Road, PLANTATION, FL, 33324 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2023-03-08 | Indiblu Management LLC | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-03-08 | 1425 SW 110th Way, Davie, FL 33324 | No data |
| CHANGE OF MAILING ADDRESS | 2019-04-27 | 150 S. Pine Island Road, Suite 300, PLANTATION, FL 33324 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-04-30 | 150 S. Pine Island Road, Suite 300, PLANTATION, FL 33324 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-06 |
| ANNUAL REPORT | 2023-03-08 |
| ANNUAL REPORT | 2022-02-09 |
| ANNUAL REPORT | 2021-03-11 |
| ANNUAL REPORT | 2020-05-05 |
| ANNUAL REPORT | 2019-04-27 |
| ANNUAL REPORT | 2018-04-30 |
| ANNUAL REPORT | 2017-05-01 |
| ANNUAL REPORT | 2016-03-27 |
| ANNUAL REPORT | 2015-04-29 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
