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 | |||||||||||||||||||||||
|
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