| Entity Name: | ENDOCRINOLOGY INSTITUTE OF SOUTH FL LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 23 Apr 2014 (11 years ago) |
| Document Number: | L14000066043 |
| FEI/EIN Number | 46-5470448 |
| Address: | 4061 BONITA BEACH RD STE 101, BONITA SPRINGS, FL 34134 |
| Mail Address: | 4061 BONITA BEACH RD STE 101, BONITA SPRINGS, FL 34134 |
| ZIP code: | 34134 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1366855975 | 2014-06-11 | 2014-07-29 | 4061 BONITA BEACH RD, STE 101, BONITA SPRINGS, FL, 341344074, US | 4061 BONITA BEACH RD, STE 101, BONITA SPRINGS, FL, 341344074, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 239-301-0105 |
| Fax | 2393010110 |
Authorized person
| Name | ORLANDO FERNANDEZ |
| Role | MEDICAL DIRECTOR |
| Phone | 2393010105 |
Taxonomy
| Taxonomy Code | 207RE0101X - Endocrinology, Diabetes & Metabolism Physician |
| License Number | ME113113 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FERNANDEZ, ORLANDO | Agent | 4061 BONITA BEACH RD STE 101, BONITA SPRINGS, FL 34134 |
| Name | Role | Address |
|---|---|---|
| FERNANDEZ, ORLANDO | President | 4061 BONITA BEACH RD STE 101, BONITA SPRINGS, FL 34134 |
| Name | Role | Address |
|---|---|---|
| FERNANDEZ, ORLANDO | Chief Executive Officer | 4061 BONITA BEACH RD STE 101, BONITA SPRINGS, FL 34134 |
| Name | Role | Address |
|---|---|---|
| Bustamante, Maria X | Chief Financial Officer | 4061 BONITA BEACH RD STE 101, BONITA SPRINGS, FL 34134 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2015-03-23 | 4061 BONITA BEACH RD STE 101, BONITA SPRINGS, FL 34134 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2014-07-18 | 4061 BONITA BEACH RD STE 101, BONITA SPRINGS, FL 34134 | No data |
| 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: 21 Jan 2025
Sources: Florida Department of State
