| Entity Name: | DEBARY FAMILY PRACTICE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 02 Dec 2015 (9 years ago) |
| Date of dissolution: | 23 Sep 2016 (8 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2016 (8 years ago) |
| Document Number: | L15000201652 |
| Address: | 609 NORTH CHARLES RICHARD BEALL BLVD., DEBARY, FL, 32713 |
| Mail Address: | 609 NORTH CHARLES RICHARD BEALL BLVD., DEBARY, FL, 32713 |
| ZIP code: | 32713 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1427413186 | 2015-12-23 | 2015-12-23 | 609 N CHARLES RICHARD BEALL BLVD, DEBARY, FL, 327132260, US | 609 N CHARLES RICHARD BEALL BLVD, DEBARY, FL, 327132260, US | |||||||||||||||
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| Phone | +1 386-668-4202 |
| Fax | 3866684207 |
Authorized person
| Name | MRS. SARA DAVILA |
| Role | PRACTICE MANAGER |
| Phone | 3522421366 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| WILLIAMS SHARON | Agent | 324 EAST PAR STREET, ORLANDO, FL, 32713 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| Name | Date |
|---|---|
| Florida Limited Liability | 2015-12-02 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
