| Entity Name: | CARLSON MEDICAL, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
CARLSON MEDICAL, PLLC 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: | 10 Dec 2015 (9 years ago) |
| Date of dissolution: | 25 Sep 2020 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2020 (5 years ago) |
| Document Number: | L15000206113 |
| FEI/EIN Number |
81-0846652
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 395 3rd St, Atlantic Beach, FL, 32233, US |
| Mail Address: | 395 3rd St, Atlantic Beach, FL, 32233, US |
| ZIP code: | 32233 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518412238 | 2016-08-23 | 2016-08-23 | 486 TOWN PLAZA AVE, SUITE 440, PONTE VEDRA, FL, 320815141, US | 486 TOWN PLAZA AVE, SUITE 440, PONTE VEDRA, FL, 320815141, US | |||||||||||||||||||
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| Phone | +1 904-395-3577 |
| Fax | 9048347821 |
Authorized person
| Name | DR. INGRID A CARLSON |
| Role | PRESIDENT |
| Phone | 9043953577 |
Taxonomy
| Taxonomy Code | 261QM2500X - Medical Specialty Clinic/Center |
| License Number | ME112115 |
| State | FL |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CARLSON MEDICAL PLLC 401 K PROFIT SHARING PLAN TRUST | 2016 | 810846652 | 2017-06-30 | CARLSON MEDICAL PLLC | 1 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2017-06-30 |
| Name of individual signing | INGRID A. CARLSON |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| CARLSON INGRID A | President | 395 THIRD STREET, ATLANTIC BEACH, FL, 32233 |
| UNITED STATES CORPORATION AGENTS, INC. | Agent | - |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000005219 | WISE WOMEN | EXPIRED | 2016-01-13 | 2021-12-31 | - | 395 THIRD STREET, ATLANTIC BEACH, FL, 32233 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2023-02-03 | 476 RIVERSIDE AVE., JACKSONVILLE, FL 32202 | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2019-08-27 | 395 3rd St, Atlantic Beach, FL 32233 | - |
| CHANGE OF MAILING ADDRESS | 2019-08-27 | 395 3rd St, Atlantic Beach, FL 32233 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2019-05-22 |
| ANNUAL REPORT | 2018-04-30 |
| ANNUAL REPORT | 2017-02-10 |
| ANNUAL REPORT | 2016-04-26 |
| Florida Limited Liability | 2015-12-10 |
Date of last update: 01 May 2025
Sources: Florida Department of State
