| Entity Name: | KANAN MEDICAL LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 22 Jun 2016 (9 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 30 Sep 2021 (3 years ago) |
| Document Number: | L16000120149 |
| FEI/EIN Number | 81-3176022 |
| Address: | 460 E. ALTAMONTE DR., SUITE 2200, ALTAMONTE SPRINGS, FL 32701 |
| Mail Address: | 460 E. ALTAMONTE DR., SUITE 2200, ALTAMONTE SPRINGS, FL 32701 |
| ZIP code: | 32701 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1962179507 | 2021-08-23 | 2021-08-23 | 460 E ALTAMONTE DR STE 2200, ALTAMONTE SPRINGS, FL, 327014653, US | 265 N CAUSEWAY, NEW SMYRNA BEACH, FL, 321695239, US | |||||||||||||||||||||||||
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| Phone | +1 407-767-0009 |
| Fax | 4077670022 |
| Phone | +1 386-387-2202 |
Authorized person
| Name | RHONDA KANAN |
| Role | PRESIDENT |
| Phone | 4073761383 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| Is Primary | No |
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | No |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KANAN MEDICAL LLC | 2023 | 813176022 | 2024-11-17 | KANAN MEDICAL LLC | 44 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-11-17 |
| Name of individual signing | SHIRLEY HORNER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-06-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 4072855127 |
| Plan sponsor’s address | 460 E ALTAMONTE DRIVE, ST 2200, ALTAMONTE SPRINGS, FL, 32701 |
Signature of
| Role | Plan administrator |
| Date | 2024-09-04 |
| Name of individual signing | NICK RICE |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-06-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 4072855127 |
| Plan sponsor’s address | 460 E ALTAMONTE DRIVE, ST 2200, ALTAMONTE SPRINGS, FL, 32701 |
Signature of
| Role | Plan administrator |
| Date | 2023-09-14 |
| Name of individual signing | SHIRLEY HORNER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| Kanan, Rhonda J | Agent | 460 E. ALTAMONTE DR., SUITE 2200, ALTAMONTE SPRINGS, FL 32701 |
| Name | Role | Address |
|---|---|---|
| KANAN, RHONDA | Authorized Member | 460 E. ALTAMONTE DR., SUITE 2200 ALTAMONTE SPRINGS, FL 32701 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000143316 | NSBMD | ACTIVE | 2020-11-06 | 2025-12-31 | No data | 265 N. CAUSEWAY, NEW SMYRNA BEACH, FL, 32169 |
| G20000123321 | NEW SMYRNA BEACH MD | ACTIVE | 2020-09-22 | 2025-12-31 | No data | 265 N. CAUSEWAY, NEW SMYRNA BEACH, FL, 32169 |
| G20000123322 | ORANGE CITY MD | ACTIVE | 2020-09-22 | 2025-12-31 | No data | 2705 REBECCA LANE, ORANGE CITY, FL, 32763 |
| G17000003641 | PARADISE PROPERTIES AT NSB | EXPIRED | 2017-01-10 | 2022-12-31 | No data | 314 FLAGLER AVENUE, NEW SMYRNA BEACH, FL, 32169 |
| G16000127477 | ALTAMONTE MD | ACTIVE | 2016-11-28 | 2027-12-31 | No data | 460 E. ALTAMONTE DRIVE, SUITE 2400, ALTAMONTE SPRINGS, FL, 32701 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-02-23 | Kanan, Rhonda J | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-23 | 460 E. ALTAMONTE DR., SUITE 2200, ALTAMONTE SPRINGS, FL 32701 | No data |
| REINSTATEMENT | 2021-09-30 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| REINSTATEMENT | 2019-10-07 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2019-10-07 | 460 E. ALTAMONTE DR., SUITE 2200, ALTAMONTE SPRINGS, FL 32701 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2017-02-22 | 460 E. ALTAMONTE DR., SUITE 2200, ALTAMONTE SPRINGS, FL 32701 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-23 |
| AMENDED ANNUAL REPORT | 2023-04-04 |
| ANNUAL REPORT | 2023-01-31 |
| ANNUAL REPORT | 2022-04-19 |
| REINSTATEMENT | 2021-09-30 |
| ANNUAL REPORT | 2020-06-26 |
| REINSTATEMENT | 2019-10-07 |
| ANNUAL REPORT | 2018-04-24 |
| ANNUAL REPORT | 2017-02-22 |
| Florida Limited Liability | 2016-06-22 |
Date of last update: 19 Jan 2025
Sources: Florida Department of State
