| Entity Name: | HEALTHY FAMILY MEDICAL GROUP, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 23 Jun 2014 (11 years ago) |
| Date of dissolution: | 22 Sep 2017 (7 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2017 (7 years ago) |
| Document Number: | L14000100254 |
| FEI/EIN Number | 47-1211790 |
| Address: | 1138 NIKKI VIEW DR, BRANDON, FL, 33511, US |
| Mail Address: | P.O. BOX 891293, TAMPA, FL, 33689 |
| ZIP code: | 33511 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1801263983 | 2015-08-25 | 2016-02-22 | PO BOX 891293, TAMPA, FL, 336891100, US | 1138 NIKKI VIEW DR, BRANDON, FL, 335114868, US | |||||||||||||||||||||||||||
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| Phone | +1 813-393-1500 |
| Fax | 8133931501 |
Authorized person
| Name | JULIA BERESFORD |
| Role | SECRETARY |
| Phone | 3406423813 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ACN415 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 208000000X - Pediatrics Physician |
| License Number | 94636 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| NEIDA VENTURA | Agent | 1138 NIKKI VIEW DR, BRANDON, FL, 33511 |
| Name | Role | Address |
|---|---|---|
| VILLEGAS FABIO | Authorized Member | P O BOX 2547, RIVERVIEW, FL, 33568 |
| VENTURA HUGO | Authorized Member | P O BOX 2547, RIVERVIEW, FL, 33568 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| LC AMENDMENT AND NAME CHANGE | 2015-07-31 | HEALTHY FAMILY MEDICAL GROUP, PLLC | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-07-31 | 1138 NIKKI VIEW DR, BRANDON, FL 33511 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-07-31 | 1138 NIKKI VIEW DR, BRANDON, FL 33511 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2016-04-25 |
| LC Amendment and Name Change | 2015-07-31 |
| ANNUAL REPORT | 2015-04-21 |
| Florida Limited Liability | 2014-06-23 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
