| Entity Name: | SHARON NICKELL-OLM M.D. FAMILY MEDICAL CENTER L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 09 Aug 2013 (11 years ago) |
| Document Number: | L13000113009 |
| FEI/EIN Number | 46-3633239 |
| Mail Address: | 1237 N. CREST CIRCLE, EUSTIS, FL, 32726, US |
| Address: | 2000 Prevatt St. Ste B, Eustis, FL, 32726, US |
| ZIP code: | 32726 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114355708 | 2013-10-17 | 2018-05-08 | 2000 PREVATT ST, EUSTIS, FL, 327266149, US | 2000 PREVATT ST, EUSTIS, FL, 327266149, US | |||||||||||||||
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| Phone | +1 352-357-2600 |
| Fax | 3523573400 |
Authorized person
| Name | SHARON ANN NICKELL-OLM |
| Role | MD |
| Phone | 3523572600 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| OLM MICHAEL E | Agent | 1237 N. CREST CIRCLE, EUSTIS, FL, 32726 |
| Name | Role | Address |
|---|---|---|
| OLM MICHAEL E | Manager | 1237 N Crest Cir, Eustis, FL, 32726 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-06-08 | 2000 Prevatt St. Ste B, Eustis, FL 32726 | No data |
| CHANGE OF MAILING ADDRESS | 2020-06-08 | 2000 Prevatt St. Ste B, Eustis, FL 32726 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-06-08 | 1237 N. CREST CIRCLE, EUSTIS, FL 32726 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-18 |
| ANNUAL REPORT | 2024-03-04 |
| ANNUAL REPORT | 2023-01-31 |
| ANNUAL REPORT | 2022-03-08 |
| ANNUAL REPORT | 2021-03-30 |
| ANNUAL REPORT | 2020-06-08 |
| ANNUAL REPORT | 2019-04-24 |
| ANNUAL REPORT | 2018-04-20 |
| ANNUAL REPORT | 2017-04-28 |
| ANNUAL REPORT | 2016-04-29 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
