| Entity Name: | VIP FAMILY PRACTICE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 13 May 2013 (12 years ago) |
| Last Event: | LC DISSOCIATION MEM |
| Event Date Filed: | 21 Oct 2014 (10 years ago) |
| Document Number: | L13000070077 |
| FEI/EIN Number | 46-0849934 |
| Address: | 401 - 403 WEST OAK STREET, KISSIMMEE, FL 34741 |
| Mail Address: | 401- 403 WEST OAK STREET, KISSIMMEE, FL 34741 |
| ZIP code: | 34741 |
| County: | Osceola |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1669725552 | 2012-10-17 | 2023-02-11 | 401 W OAK ST, KISSIMMEE, FL, 347414931, US | 401 W OAK ST, KISSIMMEE, FL, 347414931, US | |||||||||||||||||||||||||||||
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| Phone | +1 407-674-2044 |
| Fax | 4076742049 |
| Phone | +1 407-730-9911 |
| Fax | 4077303545 |
Authorized person
| Name | FRANK JOHN YANEZ |
| Role | MEDICAL DIRECTOR/OWNER |
| Phone | 4076742044 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ACN235 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 000864700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Yanez, Frank J, Dr. | Agent | 401-403 WEST OAK STREET, KISSIMMEE, FL 34741 |
| Name | Role | Address |
|---|---|---|
| YANEZ, FRANK | Managing Member | 401 - 403 WEST OAK STREET, KISSIMMEE, FL 34741 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-02-10 | 401 - 403 WEST OAK STREET, KISSIMMEE, FL 34741 | No data |
| CHANGE OF MAILING ADDRESS | 2020-02-10 | 401 - 403 WEST OAK STREET, KISSIMMEE, FL 34741 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-02-10 | 401-403 WEST OAK STREET, KISSIMMEE, FL 34741 | No data |
| REGISTERED AGENT NAME CHANGED | 2015-03-04 | Yanez, Frank J, Dr. | No data |
| LC DISSOCIATION MEM | 2014-10-21 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-29 |
| ANNUAL REPORT | 2023-01-12 |
| ANNUAL REPORT | 2022-02-07 |
| ANNUAL REPORT | 2021-03-24 |
| ANNUAL REPORT | 2020-02-10 |
| ANNUAL REPORT | 2019-04-17 |
| ANNUAL REPORT | 2018-04-09 |
| ANNUAL REPORT | 2017-04-26 |
| ANNUAL REPORT | 2016-04-27 |
| ANNUAL REPORT | 2015-03-04 |
Date of last update: 22 Jan 2025
Sources: Florida Department of State
