| Entity Name: | RICHARD CHERN MD, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 14 Aug 2015 (9 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 18 Apr 2016 (9 years ago) |
| Document Number: | L15000139389 |
| FEI/EIN Number | 47-4135963 |
| Address: | 12889 HWY 98 WEST, 107B, MIRAMAR BEACH, FLORIDA, FL, 32550, US |
| Mail Address: | 12889 HWY 98 WEST, 107B, MIRAMAR BEACH, FLORIDA, FL, 32550, US |
| ZIP code: | 32550 |
| County: | Walton |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1972983872 | 2015-06-05 | 2015-06-05 | 12889 EMERALD COAST PKWY W, SUITE 107B, MIRAMAR BEACH, FL, 325503243, US | 12889 EMERALD COAST PKWY W, SUITE 107B, MIRAMAR BEACH, FL, 325503243, US | |||||||||||||||||
|
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| Phone | +1 850-837-1271 |
Authorized person
| Name | DR. RICHARD CHERN |
| Role | OWNER |
| Phone | 8508303012 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | ME95148 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CHERN RICHARD P | Agent | 12889 HWY 98 WEST, MIRAMAR BEACH, FL, 32550 |
| Name | Role | Address |
|---|---|---|
| CHERN RICHARD P | Owner | 12889 HWY 98 WEST, SUITE 107B, MIRAMAR BEACH, FL, 32550 |
| Name | Role | Address |
|---|---|---|
| Monti Amanda | Manager | 12889 US Hwy 98 West, Suite 107B, MIRAMAR BEACH, FL, 32550 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000143088 | FLORIDA MEDICAL SUPPLY | ACTIVE | 2022-11-17 | 2027-12-31 | No data | 12889 US HWY 98 WEST, SUITE 107B, MIRAMAR BEACH, FL, 32550 |
| G19000096442 | GENETIC LIFE | EXPIRED | 2019-09-03 | 2024-12-31 | No data | 12889 US HWY 98 WEST, SUITE 107B, MIRAMAR BEACH, FL, 32550 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2016-04-27 | 12889 HWY 98 WEST, 107B, MIRAMAR BEACH, FLORIDA, FL 32550 | No data |
| LC AMENDMENT | 2016-04-18 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-03 |
| ANNUAL REPORT | 2023-03-13 |
| ANNUAL REPORT | 2022-02-07 |
| ANNUAL REPORT | 2021-02-22 |
| ANNUAL REPORT | 2020-02-03 |
| ANNUAL REPORT | 2019-01-22 |
| ANNUAL REPORT | 2018-03-29 |
| ANNUAL REPORT | 2017-03-22 |
| ANNUAL REPORT | 2016-04-27 |
| LC Amendment | 2016-04-18 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
