| Entity Name: | COLLIER MEDICAL LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 17 Jan 2013 (12 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 05 Apr 2013 (12 years ago) |
| Document Number: | L13000008740 |
| FEI/EIN Number | 46-1822468 |
| Address: | 5274 GOLDEN GATE PKWY, STE. 1, NAPLES, FL, 34116, US |
| Mail Address: | 5274 GOLDEN GATE PKWY, STE. 1, NAPLES, FL, 34116, US |
| ZIP code: | 34116 |
| County: | Collier |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891036372 | 2013-03-08 | 2013-03-08 | 15725 WILLO PINES LN, MONTVERDE, FL, 347563500, US | 12565 COLLIER BLVD, NAPLES, FL, 341165243, US | |||||||||||||||||||||
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| Phone | +1 862-377-4088 |
| Phone | +1 239-455-9919 |
| Fax | 2394559906 |
Authorized person
| Name | DR. ELVIRA TOLENTINO |
| Role | OWNER |
| Phone | 8623774088 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | ME113936 |
| State | FL |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| COLLIER MEDICAL LLC 401 K PROFIT SHARING PLAN TRUST | 2016 | 461822468 | 2017-09-29 | COLLIER MEDICAL LLC | 3 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2017-09-29 |
| Name of individual signing | ELVIRA TOLENTINO |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| TOLENTINO ELVIRA | Agent | 5274 GOLDEN GATE PKWY, STE. 1, NAPLES, FL, 34116 |
| Name | Role | Address |
|---|---|---|
| TOLENTINO ELVIRA | Managing Member | 5238 CHERRY WOOD DRIVE, NAPLES, FL, 34119 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2018-03-26 | 5274 GOLDEN GATE PKWY, STE. 1, NAPLES, FL 34116 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2014-04-18 | 5274 GOLDEN GATE PKWY, STE. 1, NAPLES, FL 34116 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-04-18 | 5274 GOLDEN GATE PKWY, STE. 1, NAPLES, FL 34116 | No data |
| LC AMENDMENT | 2013-04-05 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2013-04-05 | TOLENTINO, ELVIRA | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-07 |
| ANNUAL REPORT | 2023-03-01 |
| ANNUAL REPORT | 2022-02-17 |
| ANNUAL REPORT | 2021-03-15 |
| ANNUAL REPORT | 2020-02-20 |
| ANNUAL REPORT | 2019-01-28 |
| ANNUAL REPORT | 2018-03-26 |
| ANNUAL REPORT | 2017-04-07 |
| ANNUAL REPORT | 2016-03-04 |
| ANNUAL REPORT | 2015-02-26 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
