| Entity Name: | PEDIATRIC MEDICAL ASSOCIATES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 17 Sep 2013 (11 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | L13000131582 |
| FEI/EIN Number | 46-3712978 |
| Address: | 4445 PINE FOREST DRIVE, LAKE WORTH, FL 33463 |
| Mail Address: | P.O. BOX 542590, GREENACRES, FL 33454 |
| ZIP code: | 33463 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1700213485 | 2013-09-26 | 2014-02-26 | PO BOX 542590, GREENACRES, FL, 334542590, US | 4445 PINE FOREST DR, LAKE WORTH, FL, 334634676, US | |||||||||||||
|
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| Phone | +1 800-990-0340 |
Authorized person
| Name | TODD BRANSTETTER |
| Role | CFO |
| Phone | 8009900340 |
Taxonomy
| Taxonomy Code | 103TC2200X - Clinical Child & Adolescent Psychologist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FOSTER, ANTHONY G | Agent | 4905 LANTANA ROAD, LAKE WORTH, FL 33463 |
| Name | Role |
|---|---|
| THE ADOLESCENT TREATMENT CENTER OF THE PALM BEACHES, LLC | Managing Member |
| Name | Role | Address |
|---|---|---|
| CHERNAK, KATHLEEN D | PRESIDENT | 9556 PARKVIEW AVENUE, BOCA RATON, FL 33428 |
| Name | Role | Address |
|---|---|---|
| CHERNAK, KATHLEEN D | Chief Executive Officer | 9556 PARKVIEW AVENUE, BOCA RATON, FL 33428 |
| Name | Role | Address |
|---|---|---|
| Foster, Anthony G., Phd | Chief Operating Officer | 6564 TIMBER LANE, BOCA RATON, FL 33433 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2017-05-01 | 4445 PINE FOREST DRIVE, LAKE WORTH, FL 33463 | No data |
| REGISTERED AGENT NAME CHANGED | 2017-05-01 | FOSTER, ANTHONY G | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-01-19 |
| ANNUAL REPORT | 2017-05-01 |
| ANNUAL REPORT | 2016-04-14 |
| ANNUAL REPORT | 2015-04-30 |
| ANNUAL REPORT | 2014-03-20 |
| Florida Limited Liability | 2013-09-17 |
Date of last update: 22 Jan 2025
Sources: Florida Department of State
