| Entity Name: | CAPERNAUM MEDICAL CENTER PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 05 Jul 2016 (9 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 20 Jun 2019 (6 years ago) |
| Document Number: | L16000126536 |
| FEI/EIN Number | 81-3052257 |
| Address: | 2024 Edgewood Dr S, LAKELAND, FL, 33803, US |
| Mail Address: | 2024 Edgewood Dr S, LAKELAND, FL, 33803, US |
| ZIP code: | 33803 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1134675317 | 2016-08-29 | 2016-08-29 | PO BOX 95448, LAKELAND, FL, 338045448, US | 5129 S LAKELAND DR, UNIT 1 AND 2, LAKELAND, FL, 338132598, US | |||||||||||||||||
|
|||||||||||||||||||||
| Phone | +1 212-361-9408 |
Authorized person
| Name | ERIC R VERNIER |
| Role | PRESIDENT |
| Phone | 2123619408 |
Taxonomy
| Taxonomy Code | 2080P0210X - Pediatric Nephrology Physician |
| Is Primary | No |
| Taxonomy Code | 2084N0600X - Clinical Neurophysiology Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| VERNIER ERIC R | Agent | 2024 Edgewood Dr S, LAKELAND, FL, 33803 |
| Name | Role | Address |
|---|---|---|
| VERNIER ERIC R | Manager | 2024 Edgewood Dr S, LAKELAND, FL, 33803 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-03-01 | 2024 Edgewood Dr S, LAKELAND, FL 33803 | No data |
| CHANGE OF MAILING ADDRESS | 2023-03-01 | 2024 Edgewood Dr S, LAKELAND, FL 33803 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-03-01 | 2024 Edgewood Dr S, LAKELAND, FL 33803 | No data |
| LC AMENDMENT | 2019-06-20 | No data | No data |
| LC AMENDED/RESTATED ARTICLE/NAME CHANGE | 2016-10-14 | CAPERNAUM MEDICAL CENTER PLLC | No data |
| REGISTERED AGENT NAME CHANGED | 2016-10-14 | VERNIER, ERIC R | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-05-01 |
| ANNUAL REPORT | 2023-03-01 |
| ANNUAL REPORT | 2022-03-08 |
| ANNUAL REPORT | 2021-04-06 |
| ANNUAL REPORT | 2020-03-18 |
| LC Amendment | 2019-06-20 |
| ANNUAL REPORT | 2019-02-06 |
| ANNUAL REPORT | 2018-03-05 |
| ANNUAL REPORT | 2017-02-14 |
| LC Amended/Restated Article/NC | 2016-10-14 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
