| Entity Name: | COLUMBIA MEDICAL GROUP LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 24 Sep 2012 (12 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 25 Sep 2023 (a year ago) |
| Document Number: | L12000121807 |
| FEI/EIN Number | 46-1044940 |
| Address: | 3907 S. Jog Road, Green Acres, FL 33467 |
| Mail Address: | 2240 W WOOLBRIGHT RD, SUITE 317, BOYNTON BEACH, FL 33426 |
| ZIP code: | 33467 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1306255237 | 2014-08-05 | 2014-08-05 | 3907 S JOG RD, GREENACRES, FL, 334671590, US | 3907 S JOG RD, GREENACRES, FL, 334671590, US | |||||||||||||||||
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| Phone | +1 561-432-3455 |
Authorized person
| Name | RAMON VOILS |
| Role | ADMINISTRATIVE OFFICER |
| Phone | 5614323455 |
Taxonomy
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| License Number | ARNP9310077 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LUCIBELLA, RICHARD J | Agent | 2240 W WOOLBRIGHT RD, SUITE 317, BOYNTON BEACH, FL 33426 |
| Name | Role |
|---|---|
| PALADIN INC | Managing Member |
| GIRASOL LLC | Managing Member |
| VAINA, LLC | Managing Member |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G12000101328 | COLUMBIA MEDICAL CENTERS | EXPIRED | 2012-10-17 | 2017-12-31 | No data | 2240 W. WOOLBRIGHT RD, SUITE 317, BOYNTON BEACH, FL, 33426 |
| G12000099982 | BARCLAY MEDIAL | EXPIRED | 2012-10-12 | 2017-12-31 | No data | 2240 W. WOOLBRIGHT RD SUITE 317, BOYNTON BEACH, FL, 33426 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2023-09-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-01-12 | 3907 S. Jog Road, Green Acres, FL 33467 | No data |
| LC AMENDMENT | 2012-10-08 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2012-10-08 | 3907 S. Jog Road, Green Acres, FL 33467 | No data |
| REGISTERED AGENT NAME CHANGED | 2012-10-08 | LUCIBELLA, RICHARD J | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-10-08 | 2240 W WOOLBRIGHT RD, SUITE 317, BOYNTON BEACH, FL 33426 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-13 |
| LC Amendment | 2023-09-25 |
| ANNUAL REPORT | 2023-01-31 |
| ANNUAL REPORT | 2022-01-25 |
| ANNUAL REPORT | 2021-02-01 |
| ANNUAL REPORT | 2020-01-16 |
| ANNUAL REPORT | 2019-02-06 |
| ANNUAL REPORT | 2018-01-14 |
| ANNUAL REPORT | 2017-01-10 |
| ANNUAL REPORT | 2016-01-23 |
Date of last update: 23 Jan 2025
Sources: Florida Department of State
