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CHAD BLACK MD, LLC - Florida Company Profile

Company Details

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.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act

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

National Provider Identifier

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

Contacts

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

Key Officers & Management

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

Fictitious Names

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

Events

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 -

Documents

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