| Entity Name: | BENZER FL 5 LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 23 Apr 2015 (10 years ago) |
| Date of dissolution: | 31 Jan 2022 (3 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 31 Jan 2022 (3 years ago) |
| Document Number: | L15000071794 |
| FEI/EIN Number | 47-4119320 |
| Address: | 500 W Granada Blvd, STE 4, Ormond Beach, FL 32174 |
| Mail Address: | 500 W Granada Blvd, STE 4, Ormond Beach, FL 32174 |
| ZIP code: | 32174 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265735518 | 2010-12-08 | 2019-02-20 | 500 W GRANADA BLVD STE 4, ORMOND BEACH, FL, 321742304, US | 500 W GRANADA BLVD STE 4, ORMOND BEACH, FL, 321742304, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 386-672-0600 |
| Fax | 8882398423 |
| Fax | 3866720700 |
Authorized person
| Name | SANDRA JOHNSTON |
| Role | PRESIDENT, AO |
| Phone | 3866720600 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH29731 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 016511500 |
| State | FL |
| Issuer | PK |
| Number | 2156207 |
| Name | Role | Address |
|---|---|---|
| Bevel, Jodie | Agent | 500 W Granada Blvd, STE 4, Ormond Beach, FL 32174 |
| Name | Role | Address |
|---|---|---|
| QWIKSOLVE HOLDINGS LLC | Managing Member | PO BOX 2291, CEDAR CITY, FL 84721 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000029688 | WOW PHARMACY | ACTIVE | 2020-03-09 | 2025-12-31 | No data | 500 W. GRANADA BLVD, STE 4, ORMOND BEACH, FL, 32174 |
| G15000131445 | ORMOND PHARMACY | EXPIRED | 2015-12-29 | 2020-12-31 | No data | 500 W GRANADA BLVD, STE 4, ORMOND BEACH, FL, 32174 |
| G15000125227 | BENZER PHARMACY 144 | EXPIRED | 2015-12-11 | 2020-12-31 | No data | 125 COUNTRY CLUB DR, TAMPA, FL, 33612 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2022-01-31 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2019-02-06 | Bevel, Jodie | No data |
| LC AMENDMENT | 2018-03-20 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-03-09 | 500 W Granada Blvd, STE 4, Ormond Beach, FL 32174 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2017-03-20 | 500 W Granada Blvd, STE 4, Ormond Beach, FL 32174 | No data |
| CHANGE OF MAILING ADDRESS | 2017-03-20 | 500 W Granada Blvd, STE 4, Ormond Beach, FL 32174 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2022-01-31 |
| ANNUAL REPORT | 2021-02-05 |
| ANNUAL REPORT | 2020-01-22 |
| ANNUAL REPORT | 2019-02-06 |
| LC Amendment | 2018-03-20 |
| ANNUAL REPORT | 2018-03-09 |
| ANNUAL REPORT | 2017-03-21 |
| ANNUAL REPORT | 2016-04-29 |
| Florida Limited Liability | 2015-04-23 |
Date of last update: 20 Feb 2025
Sources: Florida Department of State
