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CHAD BLACK MD, LLC - Florida Company Profile

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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 (12 years ago)
Date of dissolution: 25 Sep 2015 (10 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 25 Sep 2015 (10 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

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

National Provider Identifier

NPI Number:
1538596309

Authorized Person:

Name:
CHAD BLACK
Role:
CEO / MEDICAL DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

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

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Date of last update: 01 Jul 2025

Sources: Florida Department of State