| Entity Name: | INTERNAL MEDICINE OF SOUTH FL LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
INTERNAL MEDICINE OF SOUTH FL 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: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 08 Apr 2014 (11 years ago) |
| Document Number: | L14000057689 |
| FEI/EIN Number |
46-5339162
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 22904 Lyden Drive, Unit 5-6, Estero, FL, 33928, US |
| Mail Address: | 22904 Lyden Drive, Unit 5-6, Estero, FL, 33928, US |
| ZIP code: | 33928 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1619387925 | 2014-05-08 | 2014-05-08 | 12264 TAMIAMI TRL E, NAPLES, FL, 341137942, US | 12264 TAMIAMI TRL E, NAPLES, FL, 341137942, US | |||||||||||||||||||||||
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| Phone | +1 239-304-9071 |
Authorized person
| Name | DR. ORLANDO FERNANDEZ |
| Role | MEDICAL DIRECTOR |
| Phone | 2393049071 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME113113 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 14LR2 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FERNANDEZ ORLANDO | Chief Executive Officer | 22904 Lyden Drive, Estero, FL, 33928 |
| Bustamante Maria | Chief Financial Officer | 22904 Lyden Drive, Estero, FL, 33928 |
| FERNANDEZ ORLANDO | Agent | 22904 Lyden Drive, Estero, FL, 33928 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-23 | 22904 Lyden Drive, Unit 5-6, Estero, FL 33928 | - |
| CHANGE OF MAILING ADDRESS | 2024-03-23 | 22904 Lyden Drive, Unit 5-6, Estero, FL 33928 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2024-03-23 | 22904 Lyden Drive, Unit 5-6, Estero, FL 33928 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-23 |
| ANNUAL REPORT | 2023-04-04 |
| ANNUAL REPORT | 2022-03-14 |
| ANNUAL REPORT | 2021-03-07 |
| ANNUAL REPORT | 2020-03-20 |
| ANNUAL REPORT | 2019-03-28 |
| ANNUAL REPORT | 2018-03-09 |
| ANNUAL REPORT | 2017-01-20 |
| ANNUAL REPORT | 2016-03-05 |
| ANNUAL REPORT | 2015-03-23 |
Date of last update: 03 Mar 2025
Sources: Florida Department of State
