| Entity Name: | CHAD BLACK MD, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
CHAD BLACK MD, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 01 Oct 2013 (11 years ago) |
| Date of dissolution: | 25 Sep 2015 (9 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2015 (9 years ago) |
| Document Number: | L13000137980 |
| FEI/EIN Number |
46-3784241
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 8390 Champions Gate Blvd, Champions Gate, FL, 33896-8311, US |
| Mail Address: | 8390 Champions Gate Blvd, Champions Gate, FL, 33896-8311, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538596309 | 2013-10-10 | 2013-10-10 | 610 SYCAMORE STREET SUITE 130, CELEBRATION, FL, 34747, US | 610 SYCAMORE STREET SUITE 130, CELEBRATION, FL, 34747, US | |||||||||||||||
|
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| Phone | +1 321-287-6955 |
Authorized person
| Name | CHAD BLACK |
| Role | CEO / MEDICAL DIRECTOR |
| Phone | 3212876955 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BLACK CHAD R | Managing Member | 526 GREENBRIER AVE, CELEBRATION, FL, 34747 |
| BLACK TENNILLE E | Managing Member | 526 GREENBRIER AVE, CELEBRATION, FL, 34747 |
| BLACK TENNILLE E | Agent | 526 GREENBRIER AVE, CELEBRATION, FL, 34747 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G13000115151 | SNF PRO | EXPIRED | 2013-11-23 | 2018-12-31 | - | 549 WATER STREET, CELEBRATION, FL, 34747 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2014-05-01 | 8390 Champions Gate Blvd, Suite 108, Champions Gate, FL 33896-8311 | - |
| CHANGE OF MAILING ADDRESS | 2014-05-01 | 8390 Champions Gate Blvd, Suite 108, Champions Gate, FL 33896-8311 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2014-05-01 |
| Florida Limited Liability | 2013-10-01 |
Date of last update: 01 Mar 2025
Sources: Florida Department of State
