| Entity Name: | PROVIDENT ORTHOPEDIC AND SPORTS MEDICINE CENTER LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 26 May 2016 (9 years ago) |
| Document Number: | L16000108711 |
| FEI/EIN Number | 812757988 |
| Address: | 801 Marshall Farms Rd, Ocoee, FL, 34761, US |
| Mail Address: | 11042 LAKE BUTLER BLVD, WINDERMERE, FL, 34786, US |
| ZIP code: | 34761 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1952750713 | 2016-06-11 | 2024-09-14 | 801 MARSHALL FARMS RD, OCOEE, FL, 347613316, US | 801 MARSHALL FARMS RD, OCOEE, FL, 347613316, US | |||||||||||||||
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| Phone | +1 407-906-3621 |
| Fax | 4076143171 |
Authorized person
| Name | PAUL F SHULER |
| Role | MANAGER |
| Phone | 9203448665 |
Taxonomy
| Taxonomy Code | 207X00000X - Orthopaedic Surgery Physician |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PFS PENSION PLAN | 2019 | 812757988 | 2020-10-12 | PROVIDENT ORTHOPEDIC AND SPORTS MEDICINE CENTER | 2 | |||||||||||||
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| PFS PENSION PLAN | 2018 | 812757988 | 2019-10-15 | PROVIDENT ORTHOPEDIC AND SPORTS MEDICINE CENTER | 2 | |||||||||||||
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| Name | Role | Address |
|---|---|---|
| SHULER PAUL F | Agent | 11042 LAKE BUTLER BLVD, WINDERMERE, FL, 34786 |
| Name | Role | Address |
|---|---|---|
| SHULER PAUL F | Manager | 11042 LAKE BUTLER BLVD, WINDERMERE, FL, 34786 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-01-04 | 801 Marshall Farms Rd, Ocoee, FL 34761 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-14 |
| ANNUAL REPORT | 2023-03-11 |
| ANNUAL REPORT | 2022-01-04 |
| ANNUAL REPORT | 2021-01-04 |
| ANNUAL REPORT | 2020-01-12 |
| ANNUAL REPORT | 2019-02-18 |
| ANNUAL REPORT | 2018-01-14 |
| ANNUAL REPORT | 2017-01-06 |
| Florida Limited Liability | 2016-05-26 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
