| Entity Name: | TOWN CENTER FAMILY MEDICINE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 12 Jun 2012 (13 years ago) |
| Date of dissolution: | 22 Sep 2017 (7 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2017 (7 years ago) |
| Document Number: | L12000078687 |
| FEI/EIN Number | 90-0856965 |
| Address: | 610 SYCAMORE STREET, CELEBRATION, FL, 34747, US |
| Mail Address: | 610 SYCAMORE STREET, CELEBRATION, FL, 34747, US |
| ZIP code: | 34747 |
| County: | Osceola |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1790047934 | 2012-06-13 | 2015-03-27 | 610 SYCAMORE ST, SUITE 130, CELEBRATION, FL, 347474995, US | 610 SYCAMORE ST, SUITE 130, CELEBRATION, FL, 347474995, US | |||||||||||||||||||||
|
|||||||||||||||||||||||||
| Phone | +1 386-788-6616 |
Authorized person
| Name | CHAD BLACK |
| Role | OWNER/PARTNER |
| Phone | 3867886616 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 332900000X - Non-Pharmacy Dispensing Site |
| License Number | ME100993 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| BLACK CHAD | Agent | 610 SYCAMORE STREET, CELEBRATION, FL, 34747 |
| Name | Role | Address |
|---|---|---|
| BLACK CHAD | Managing Member | 610 SYCAMORE ST., CELEBRATION, FL, 34747 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G12000072199 | TOWN CENTER MEDICAL | EXPIRED | 2012-07-19 | 2017-12-31 | No data | 610 SYCAMORE STREET, SUITE 130, CELEBRATION, FL, 34747 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-10-13 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2016-10-12 | BLACK, CHAD | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-10-12 | 610 SYCAMORE STREET, STE. 130, CELEBRATION, FL 34747 | No data |
| CHANGE OF MAILING ADDRESS | 2016-10-12 | 610 SYCAMORE STREET, STE. 130, CELEBRATION, FL 34747 | No data |
| REINSTATEMENT | 2016-10-12 | No data | No data |
| LC REVOCATION OF DISSOLUTION | 2016-10-12 | No data | No data |
| LC VOLUNTARY DISSOLUTION | 2016-06-27 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-04-11 | 610 SYCAMORE STREET, STE. 130, CELEBRATION, FL 34747 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J18000082701 | ACTIVE | 1000000771617 | OSCEOLA | 2018-02-19 | 2028-02-28 | $ 421.07 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, ORLANDO SERVICE CENTER, 400 W ROBINSON ST STE N302, ORLANDO FL328011759 |
| J18000013805 | ACTIVE | 1000000764147 | OSCEOLA | 2017-12-15 | 2028-01-10 | $ 1,422.59 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, ORLANDO SERVICE CENTER, 400 W ROBINSON ST STE N302, ORLANDO FL328011759 |
| J16000235535 | ACTIVE | 1000000707551 | OSCEOLA | 2016-03-11 | 2026-04-06 | $ 1,700.38 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, ORLANDO SERVICE CENTER, 400 W ROBINSON ST STE N302, ORLANDO FL328011759 |
| Name | Date |
|---|---|
| Reinstatement | 2016-10-12 |
| LC Revocation of Dissolution | 2016-10-12 |
| LC Voluntary Dissolution | 2016-06-27 |
| ANNUAL REPORT | 2015-04-22 |
| ANNUAL REPORT | 2014-04-30 |
| ANNUAL REPORT | 2013-04-11 |
| Florida Limited Liability | 2012-06-12 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
