| Entity Name: | CONTINI FAMILY MEDICINE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 29 May 2015 (10 years ago) |
| Document Number: | L15000094969 |
| FEI/EIN Number | 47-4162767 |
| Address: | 3269 US 90 EAST, BONIFAY, FL, 32425, US |
| Mail Address: | 3269 US 90 EAST, BONIFAY, FL, 32425, US |
| ZIP code: | 32425 |
| County: | Holmes |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1316314305 | 2015-08-26 | 2015-08-26 | 3269 HIGHWAY 90, BONIFAY, FL, 324256001, US | 3269 HIGHWAY 90, BONIFAY, FL, 324256001, US | |||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||
| Phone | +1 850-547-9991 |
| Fax | 8505479992 |
Authorized person
| Name | REBEKAH E CONTINI |
| Role | PHYSICIAN |
| Phone | 8505479991 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ME118029 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 014273300 |
| State | FL |
| Issuer | NPI |
| Number | 1598026429 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CONTINI KYLE V | Agent | 3269 US 90 EAST, BONIFAY, FL, 32425 |
| Name | Role | Address |
|---|---|---|
| CONTINI KYLE V | Authorized Member | 3269 US 90 EAST, BONIFAY, FL, 32425 |
| CONTINI REBEKAH E | Authorized Member | 3269 US 90 EAST, BONIFAY, FL, 32425 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G15000099039 | WELCH FAMILY MEDICINE | EXPIRED | 2015-09-28 | 2020-12-31 | No data | 3269 US 90 EAST, BONIFAY, FL, 32425 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-02 |
| ANNUAL REPORT | 2024-01-03 |
| ANNUAL REPORT | 2023-01-04 |
| ANNUAL REPORT | 2022-01-06 |
| ANNUAL REPORT | 2021-01-07 |
| ANNUAL REPORT | 2020-01-13 |
| ANNUAL REPORT | 2019-01-11 |
| ANNUAL REPORT | 2018-01-09 |
| ANNUAL REPORT | 2017-01-13 |
| ANNUAL REPORT | 2016-01-14 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
