| Entity Name: | MT. CARMEL PEDIATRICS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 06 Feb 2013 (12 years ago) |
| Date of dissolution: | 23 Sep 2022 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (2 years ago) |
| Document Number: | L13000019205 |
| FEI/EIN Number | 46-1982355 |
| Address: | 1325 S. Congress Ave., BOYNTON BEACH, FL, 33426, US |
| Mail Address: | 1325 S. Congress Ave., BOYNTON BEACH, FL, 33426, US |
| ZIP code: | 33426 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1932441144 | 2013-03-26 | 2013-10-29 | 200 KNUTH RD, SUITE 106, BOYNTON BEACH, FL, 334364629, US | 200 KNUTH RD, SUITE 106, BOYNTON BEACH, FL, 334364629, US | |||||||||||||||||||||||||||||||
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| Phone | +1 561-600-9015 |
| Fax | 5616009016 |
Authorized person
| Name | DR. JEANNE GO |
| Role | MGRM |
| Phone | 5616009015 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| License Number | ME0041663 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 067795700 |
| State | FL |
| Issuer | MEDICAID |
| Number | 265620500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GO JEANNE U | Agent | 1325 S. Congress Ave., BOYNTON BEACH, FL, 33426 |
| Name | Role | Address |
|---|---|---|
| GO JEANNE U | Managing Member | 1325 S. Congress Ave., BOYNTON BEACH, FL, 33426 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-07 | 1325 S. Congress Ave., Ste 109, BOYNTON BEACH, FL 33426 | No data |
| CHANGE OF MAILING ADDRESS | 2021-04-07 | 1325 S. Congress Ave., Ste 109, BOYNTON BEACH, FL 33426 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-04-07 | 1325 S. Congress Ave., Ste 109, BOYNTON BEACH, FL 33426 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2021-04-07 |
| ANNUAL REPORT | 2020-06-24 |
| ANNUAL REPORT | 2019-05-01 |
| ANNUAL REPORT | 2018-05-01 |
| ANNUAL REPORT | 2017-04-30 |
| ANNUAL REPORT | 2016-03-10 |
| ANNUAL REPORT | 2015-03-19 |
| ANNUAL REPORT | 2014-05-02 |
| Florida Limited Liability | 2013-02-06 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
