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  5. TEQUESTA FAMILY MEDICAL CENTER LLC

TEQUESTA FAMILY MEDICAL CENTER LLC

Company Details

Entity Name: TEQUESTA FAMILY MEDICAL CENTER LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 10 Sep 2012 (12 years ago)
Document Number: L12000115577
FEI/EIN Number 46-0960423
Address: 851 N US HIGHWAY 1, TEQUESTA, FL, 33469
Mail Address: 851 N US HIGHWAY 1, TEQUESTA, FL, 33469
ZIP code: 33469
County: Palm Beach
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1396099883 2012-11-05 2012-11-05 851 N US HIGHWAY 1, TEQUESTA, FL, 334692348, US 851 N US HIGHWAY 1, TEQUESTA, FL, 334692348, US

Contacts
Phone +1 561-743-8362

Authorized person
Name MARK LANGE CORRY
Role PRESIDENT
Phone 5617438362

Taxonomy
Taxonomy Code 207Q00000X - Family Medicine Physician
License Number ME78193
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
TEQUESTA FAMILY MEDICAL CENTER 401(K) PROFIT SHARING PLAN & TRUST 2023 460960423 2024-06-28 TEQUESTA FAMILY MEDICAL CENTER 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 812990
Sponsor’s telephone number 5617472000
Plan sponsor’s address 851 N US HIGHWAY 1, TEQUESTA, FL, 33469

Signature of
Role Plan administrator
Date 2024-06-28
Name of individual signing MARK CORRY
Valid signature Filed with authorized/valid electronic signature
TEQUESTA FAMILY MEDICAL CENTER 401(K) PROFIT SHARING PLAN & TRUST 2022 460960423 2023-04-04 TEQUESTA FAMILY MEDICAL CENTER 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 812990
Sponsor’s telephone number 5617472000
Plan sponsor’s address 851 N US HIGHWAY 1, TEQUESTA, FL, 33469

Signature of
Role Plan administrator
Date 2023-04-04
Name of individual signing MARK CORRY
Valid signature Filed with authorized/valid electronic signature
TEQUESTA FAMILY MEDICAL CENTER 401(K) PROFIT SHARING PLAN & TRUST 2021 460960423 2022-04-01 TEQUESTA FAMILY MEDICAL CENTER 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 812990
Sponsor’s telephone number 5617472000
Plan sponsor’s address 851 N US HIGHWAY 1, TEQUESTA, FL, 33469

Signature of
Role Plan administrator
Date 2022-04-01
Name of individual signing MARK CORRY
Valid signature Filed with authorized/valid electronic signature
TEQUESTA FAMILY MEDICAL CENTER 401(K) PROFIT SHARING PLAN & TRUST 2020 460960423 2021-06-06 TEQUESTA FAMILY MEDICAL CENTER 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 812990
Sponsor’s telephone number 5617472000
Plan sponsor’s address 851 N US HIGHWAY 1, TEQUESTA, FL, 33469

Signature of
Role Plan administrator
Date 2021-06-06
Name of individual signing MARK CORRY
Valid signature Filed with authorized/valid electronic signature
TEQUESTA FAMILY MEDICAL CENTER 401(K) PROFIT SHARING PLAN & TRUST 2019 460960423 2020-05-29 TEQUESTA FAMILY MEDICAL CENTER 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 812990
Sponsor’s telephone number 5617472000
Plan sponsor’s address 851 N US HIGHWAY 1, TEQUESTA, FL, 33469

Signature of
Role Plan administrator
Date 2020-05-29
Name of individual signing MARK CORRY
Valid signature Filed with authorized/valid electronic signature
TEQUESTA FAMILY MEDICAL CENTER 401 K PROFIT SHARING PLAN TRUST 2017 460960423 2018-10-10 TEQUESTA FAMILY MEDICAL CENTER 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 812990
Sponsor’s telephone number 5617472000
Plan sponsor’s address 851 N US HIGHWAY 1, TEQUESTA, FL, 33469

Signature of
Role Plan administrator
Date 2018-10-10
Name of individual signing MARK CORRY
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
CORRY MARK LDr. Agent 851 N US HIGHWAY 1, TEQUESTA, FL, 33469

Manager

Name Role Address
CORRY MARK L Manager 851 N US HIGHWAY 1, TEQUESTA, FL, 33469

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2013-04-25 CORRY, MARK L, Dr. No data

Documents

Name Date
ANNUAL REPORT 2024-04-16
ANNUAL REPORT 2023-04-10
ANNUAL REPORT 2022-04-22
ANNUAL REPORT 2021-04-17
ANNUAL REPORT 2020-05-15
ANNUAL REPORT 2019-04-27
ANNUAL REPORT 2018-03-11
ANNUAL REPORT 2017-04-23
ANNUAL REPORT 2016-03-12
ANNUAL REPORT 2015-02-21

Related by officers

CORRY MARK L

395 TEQUESTA DRIVE, LLC MARK L. CORRY, M.D., LLC TEQUESTA FAMILY PROPERTIES LLC

CORRY MARK LDr.

MARK L. CORRY, M.D., LLC

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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