| Entity Name: | LIEBELT FAMILY MEDICINE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Company
LIEBELT FAMILY MEDICINE, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 26 Oct 2015 (9 years ago) |
| Date of dissolution: | 28 Jul 2021 (4 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 28 Jul 2021 (4 years ago) |
| Document Number: | L15000181155 |
| FEI/EIN Number |
47-5447100
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 3515 SE 17TH STREET, SUITE 100, OCALA, FL 34471 |
| Mail Address: | 3515 SE 17TH STREET, SUITE 100, OCALA, FL 34471 |
| ZIP code: | 34471 |
| County: | Marion |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1427421130 | 2015-11-03 | 2015-11-03 | 3515 SE 17TH ST, SUITE 100, OCALA, FL, 344715586, US | 3515 SE 17TH ST, SUITE 100, OCALA, FL, 344715586, US | |||||||||||||||||||||||||
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| Phone | +1 352-509-9470 |
| Fax | 3528617725 |
Authorized person
| Name | DR. DONALD W LIEBELT |
| Role | CEO |
| Phone | 3525099470 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ME0056468 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS FL |
| Number | 10600U |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LIEBELT, SUSAN G | Agent | 3515 SE 17TH STREET, #100, OCALA,, FL 34471 |
| LIEBELT, DONALD W, MD | Chief Executive Officer | 3515 SE 17TH STREET, #100, OCALA, FL 34471 |
| LIEBELT, SUSAN G | Vice President | 3515 SE 17TH STREET, #100, OCALA, FL 34471 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2021-07-28 | - | - |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2021-07-28 |
| ANNUAL REPORT | 2020-03-03 |
| ANNUAL REPORT | 2019-04-03 |
| ANNUAL REPORT | 2018-03-13 |
| ANNUAL REPORT | 2017-03-15 |
| ANNUAL REPORT | 2016-01-15 |
| Florida Limited Liability | 2015-10-26 |
Date of last update: 19 Feb 2025
Sources: Florida Department of State
