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GENESIS FAMILY PRACTICE LLC - Florida Company Profile

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Company Details

Entity Name: GENESIS FAMILY PRACTICE LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

GENESIS FAMILY PRACTICE 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.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act

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: 24 Sep 2012 (13 years ago)
Document Number: L12000121864
FEI/EIN Number 46-1045369

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 1133 SAXON BLVD, ORANGE CITY, FL, 32763
Mail Address: 1133 SAXON BLVD, ORANGE CITY, FL, 32763
ZIP code: 32763
County: Volusia
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
CHANMUGAM JAY MGN 1133 SAXON BLVD, ORANGE CITY, FL, 32763
CHANMUGAM JAY Agent 1133 SAXON BLVD, ORANGE CITY, FL, 32763

National Provider Identifier

NPI Number:
1447799242
Certification Date:
2022-11-28

Authorized Person:

Name:
JAY C CHANMUGAM
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
208D00000X - General Practice Physician
Is Primary:
Yes

Contacts:

Fax:
3862289701
Fax:
3866769050

Form 5500 Series

Employer Identification Number (EIN):
461045369
Plan Year:
2019
Number Of Participants:
41
Sponsors Telephone Number:
Plan Year:
2018
Number Of Participants:
20
Sponsors Telephone Number:
Plan Year:
2017
Number Of Participants:
14
Sponsors Telephone Number:
Plan Year:
2016
Number Of Participants:
1
Sponsors Telephone Number:
Plan Year:
2016
Number Of Participants:
1
Sponsors Telephone Number:

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G15000051757 HOME DOC'S EXPIRED 2015-05-27 2020-12-31 - 1133 SAXON BLVD, STE 200, ORANGE CITY, FL, 32713

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2021-01-13 1133 SAXON BLVD, ORANGE CITY, FL 32763 -

Documents

Name Date
ANNUAL REPORT 2025-02-07
ANNUAL REPORT 2024-02-07
ANNUAL REPORT 2023-02-02
ANNUAL REPORT 2022-02-24
ANNUAL REPORT 2021-01-13
ANNUAL REPORT 2020-03-24
ANNUAL REPORT 2019-03-06
ANNUAL REPORT 2018-04-30
ANNUAL REPORT 2017-03-31
ANNUAL REPORT 2016-04-29

USAspending Awards / Financial Assistance

Date:
2020-06-17
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO PROVIDE LOANS TO RESTORE AS NEARLY AS POSSIBLE THE VICTIMS OF ECONOMIC INJURY TYPE DISASTERS TO PRE-DISASTER CONDITIONS
Obligated Amount:
0.00
Face Value Of Loan:
150000.00
Total Face Value Of Loan:
150000.00
Date:
2020-05-01
Awarding Agency Name:
Small Business Administration
Transaction Description:
ECONOMIC INJURY DISASTER GRANT
Obligated Amount:
10000.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2020-04-16
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
222500.00
Total Face Value Of Loan:
222500.00

Paycheck Protection Program

Date Approved:
2020-04-16
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
222500
Current Approval Amount:
222500
Race:
American Indian or Alaska Native
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
225584.52

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Date of last update: 02 Jul 2025

Sources: Florida Department of State