| Entity Name: | INDEPENDENT MEDICAL GROUP, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 11 Jun 2014 (11 years ago) |
| Date of dissolution: | 04 Jan 2024 (a year ago) |
| Last Event: | CONVERSION |
| Event Date Filed: | 04 Jan 2024 (a year ago) |
| Document Number: | L14000093814 |
| FEI/EIN Number | 47-1073466 |
| Address: | 5701 NW 88th Ave, Tamarac, FL, 33321, US |
| Mail Address: | 5701 NW 88th Ave, Tamarac, FL, 33321, US |
| ZIP code: | 33321 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518746460 | 2023-09-28 | 2023-09-28 | 5701 NW 88TH AVE STE 390, TAMARAC, FL, 333214451, US | 3900 S FLORIDA AVE STE 205, LAKELAND, FL, 338131150, US | |||||||||||||||
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| Phone | +1 407-860-0283 |
| Phone | +1 800-773-7066 |
Authorized person
| Name | SONIA N TORRES |
| Role | DIRECTOR OF PROJECTS |
| Phone | 4078600283 |
Taxonomy
| Taxonomy Code | 207RI0200X - Infectious Disease Physician |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| INDEPENDENT MEDICAL GROUP, LLC 401(K) PROFIT SHARING PLAN | 2023 | 471073466 | 2024-10-07 | INDEPENDENT MEDICAL GROUP, LLC | 54 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-10-07 |
| Name of individual signing | JOSHUA GREEN |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2020-01-01 |
| Business code | 446110 |
| Sponsor’s telephone number | 9548546836 |
| Plan sponsor’s address | 3800 INVERARRY BLVD., SUITE 109, FORT LAUDERDALE, FL, 33319 |
Signature of
| Role | Plan administrator |
| Date | 2023-10-06 |
| Name of individual signing | JOSHUA GREEN |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2020-01-01 |
| Business code | 446110 |
| Sponsor’s telephone number | 9543148080 |
| Plan sponsor’s address | 3800 INVERARRY BLVD, SUITE 109, FORT LAUDERDALE, FL, 33319 |
Signature of
| Role | Plan administrator |
| Date | 2022-06-23 |
| Name of individual signing | CLIFFORD W. KNIGHTS, II |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role |
|---|---|
| REGISTERED AGENTS INC | Agent |
| Name | Role | Address |
|---|---|---|
| Knights Clifford WII | Chief Executive Officer | 5701 NW 88th Ave, Tamarac, FL, 33321 |
| Name | Role | Address |
|---|---|---|
| VIXAMAR STEVE | Chief Operating Officer | 5701 NW 88th Ave, Tamarac, FL, 33321 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000123827 | IMG HEALTH CLINIC | ACTIVE | 2020-09-23 | 2025-12-31 | No data | INDEPENDENT MEDICAL GROUP, LLC, 5701 NW 88TH AVE, SUITE 390, TAMARAC, FL, 33321 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-01-10 | 7901 4th ST N, Ste 300, St. Petersburg, FL 33702 | No data |
| CONVERSION | 2024-01-04 | No data | CONVERSION MEMBER. NON-QUALIFIED CORPORATION WAS HEALTH MD CLINICAL, LLC A NON-QUALI. CONVERSION NUMBER 500000248815 |
| CHANGE OF PRINCIPAL ADDRESS | 2023-02-07 | 5701 NW 88th Ave, SUITE 390, Tamarac, FL 33321 | No data |
| CHANGE OF MAILING ADDRESS | 2023-02-07 | 5701 NW 88th Ave, SUITE 390, Tamarac, FL 33321 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-02-07 | Registered Agents Inc | No data |
| REINSTATEMENT | 2017-09-28 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-10 |
| Conversion | 2024-01-04 |
| ANNUAL REPORT | 2023-02-07 |
| ANNUAL REPORT | 2022-03-30 |
| ANNUAL REPORT | 2021-02-26 |
| ANNUAL REPORT | 2020-01-17 |
| ANNUAL REPORT | 2019-02-18 |
| ANNUAL REPORT | 2018-01-29 |
| REINSTATEMENT | 2017-09-28 |
| ANNUAL REPORT | 2016-04-25 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
