| Entity Name: | MEDICAL HOME ALLIANCE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 28 Dec 2012 (12 years ago) |
| Last Event: | CORPORATE MERGER |
| Event Date Filed: | 20 Nov 2024 (2 months ago) |
| Document Number: | L12000161940 |
| FEI/EIN Number | 46-1640939 |
| Address: | 6675 Westwood Blvd., Ste 475, Orlando, FL 32821 |
| Mail Address: | 6675 Westwood Blvd., Ste 475, Orlando, FL 32821 |
| ZIP code: | 32821 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548917404 | 2022-03-09 | 2022-03-09 | 6675 WESTWOOD BLVD STE 475, ORLANDO, FL, 328216027, US | 2757 CITRUS TOWER BLVD STE 101&103, CLERMONT, FL, 347116699, US | |||||||||||||||||||||
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| Phone | +1 407-845-0330 |
Authorized person
| Name | VANESSA HOURIHAN |
| Role | VP REVENUE CYCLE |
| Phone | 4078450322 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | No |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MEDICAL HOME ALLIANCE LLC 401K PROFIT SHARING PLAN & TRUST | 2018 | 461640939 | 2019-10-14 | MEDICAL HOME ALLIANCE LLC | 80 | |||||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2019-10-14 |
| Name of individual signing | PATRICIA PICHARDO |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2019-10-14 |
| Name of individual signing | PATRICIA PICHARDO |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2015-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 8635881424 |
| Plan sponsor’s address | 111 WEBB DRIVE, DAVENPORT, FL, 33837 |
Signature of
| Role | Plan administrator |
| Date | 2018-05-30 |
| Name of individual signing | PATRICIA PICHARDO |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2015-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 8635881424 |
| Plan sponsor’s address | 111 WEBB DRIVE, DAVENPORT, FL, 33837 |
Signature of
| Role | Plan administrator |
| Date | 2017-07-28 |
| Name of individual signing | PATRICIA PICHARDO |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| ct corporation system | Agent | 1200 south pine island rd, plantation, FL 33324 |
| Name | Role | Address |
|---|---|---|
| Liebermann, Ethan | Manager | 6675 Westwood Blvd., Ste 475 Orlando, FL 32821 |
| Carter, Mark | Manager | 6675 Westwood Blvd., Ste 475 Orlando, FL 32821 |
| Walker, Donna | Manager | 6675 Westwood Blvd., Ste 475 Orlando, FL 32821 |
| Name | Role | Address |
|---|---|---|
| Haughton, Elizabeth | Secretary | 6675 Westwood Blvd., Ste 475 Orlando, FL 32821 |
| Name | Role | Address |
|---|---|---|
| Haughton, Elizabeth | General Counsel | 6675 Westwood Blvd., Ste 475 Orlando, FL 32821 |
| Name | Role | Address |
|---|---|---|
| Haughton, Elizabeth | Chief Compliance Officer | 6675 Westwood Blvd., Ste 475 Orlando, FL 32821 |
| Name | Role | Address |
|---|---|---|
| Serio, Shannon | Treasurer and Assistant Secretary | 6675 Westwood Blvd., Ste 475 Orlando, FL 32821 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000152399 | IMA MEDICAL CLINIC | ACTIVE | 2024-12-16 | 2029-12-31 | No data | 6675 WESTWOOD BLVD STE 475, ORLANDO, FL, 32821 |
| G24000132580 | IMA MEDICAL CENTER | ACTIVE | 2024-10-29 | 2029-12-31 | No data | 6675 WESTWOOD BLVD STE 475, ORLANDO, FL, 32821 |
| G24000096232 | IMA WELLNESS CENTER | ACTIVE | 2024-08-13 | 2029-12-31 | No data | 6675 WESTWOOD BLVD STE 475, ORLANDO, FL, 32821 |
| G24000084227 | THE PICHARDO CLINIC | ACTIVE | 2024-07-15 | 2029-12-31 | No data | 6675 WESTWOOD BLVD STE 475, ORLANDO, FL, 32821 |
| G24000084229 | TOTAL PATIENT CARE | ACTIVE | 2024-07-15 | 2029-12-31 | No data | 6675 WESTWOOD BLVD STE 475, ORLANDO, FL, 32821 |
| G18000024485 | IMA MEDICAL GROUP | ACTIVE | 2018-02-16 | 2028-12-31 | No data | 6675 WESTWOOD BLVD, 475, ORLANDO, FL, 32821 |
| G16000066593 | IMA FAMILY MEDICAL | EXPIRED | 2016-07-06 | 2021-12-31 | No data | 111 WEBB DRIVE, DAVENPORT, FL, 33837 |
| G13000105361 | IMA MEDICAL CENTER | EXPIRED | 2013-10-25 | 2018-12-31 | No data | 8367 VIA ROSA, APT/SUITE, ORLANDO, FL, 32836 |
| G13000039477 | IMA WELLNESS CENTER | EXPIRED | 2013-04-24 | 2018-12-31 | No data | 111 WEBB DRIVE, SUITE 2, DAVENPORT, FL, 33837 |
| G13000039478 | IMA MEDICAL CENTER | EXPIRED | 2013-04-24 | 2018-12-31 | No data | 111 WEBB DRIVE, DAVENPORT, FL, 33837 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| MERGER | 2024-11-20 | No data | CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 1. MERGER NUMBER 700000260817 |
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-25 | 6675 Westwood Blvd., Ste 475, Orlando, FL 32821 | No data |
| CHANGE OF MAILING ADDRESS | 2024-03-25 | 6675 Westwood Blvd., Ste 475, Orlando, FL 32821 | No data |
| MERGER | 2021-01-19 | No data | CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 1. MERGER NUMBER 500000209755 |
| MERGER | 2021-01-14 | No data | CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 1. MERGER NUMBER 100000209751 |
| MERGER | 2021-01-04 | No data | CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 1. MERGER NUMBER 100000209391 |
| REGISTERED AGENT ADDRESS CHANGED | 2019-03-18 | 1200 south pine island rd, plantation, FL 33324 | No data |
| LC STMNT OF RA/RO CHG | 2019-03-18 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2019-03-18 | ct corporation system | No data |
| LC AMENDMENT | 2018-12-20 | No data | No data |
| Name | Date |
|---|---|
| Merger | 2024-11-20 |
| AMENDED ANNUAL REPORT | 2024-10-28 |
| ANNUAL REPORT | 2024-03-25 |
| ANNUAL REPORT | 2023-01-25 |
| AMENDED ANNUAL REPORT | 2022-07-06 |
| ANNUAL REPORT | 2022-03-31 |
| AMENDED ANNUAL REPORT | 2021-05-05 |
| Merger | 2021-01-19 |
| ANNUAL REPORT | 2021-01-14 |
| Merger | 2021-01-14 |
Date of last update: 23 Jan 2025
Sources: Florida Department of State
