| Entity Name: | CONCIERGE FAMILY MEDICAL, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 20 Jul 2015 (10 years ago) |
| Date of dissolution: | 30 Apr 2017 (8 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 30 Apr 2017 (8 years ago) |
| Document Number: | L15000123427 |
| FEI/EIN Number | 47-4606707 |
| Address: | 13506 SUMMERPORT VILLAGE PKWY, WINDERMERE, FL, 34786, US |
| Mail Address: | 13512 RIGGS WAY, WINDERMERE, FL, 34786, US |
| ZIP code: | 34786 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1093191454 | 2015-08-07 | 2015-08-07 | 13506 SUMMERPORT VILLAGE PKWY, STE 735, WINDERMERE, FL, 347867366, US | 13506 SUMMERPORT VILLAGE PKWY, STE 735, WINDERMERE, FL, 347867366, US | |||||||||||||||||
|
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| Phone | +1 407-414-5377 |
Authorized person
| Name | JESSICA E BEAN |
| Role | FAMILY NURSE PRACTIONER |
| Phone | 4074145377 |
Taxonomy
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| License Number | L15000123427 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BEAN JESSICA E | Agent | 13512 RIGGS WAY, WINDERMERE, FL, 34786 |
| Name | Role | Address |
|---|---|---|
| BEAN JESSICA E | Manager | 13512 RIGGS WAY, WINDERMERE, FL, 34786 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2017-04-30 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-07-30 | 13506 SUMMERPORT VILLAGE PKWY, STE 735, WINDERMERE, FL 34786 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2017-04-30 |
| ANNUAL REPORT | 2016-04-29 |
| Florida Limited Liability | 2015-07-20 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
