| Entity Name: | MY FAMILY MEDICAL GROUP LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 18 Jul 2016 (9 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | L16000134559 |
| FEI/EIN Number | 81-3322619 |
| Address: | 505 GREENBROUGH DR, LAKE WALES, FL 33853 |
| Mail Address: | 505 GREENBROUGH DR, LAKE WALES, FL 33853 |
| ZIP code: | 33853 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1255888160 | 2016-09-08 | 2016-09-08 | 4311 ANDERSON RD, ORLANDO, FL, 328127358, US | 4311 ANDERSON RD, ORLANDO, FL, 328127358, US | |||||||||||||||||
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| Fax | 7879317755 |
Authorized person
| Name | DR. CARLOS R CARDONA |
| Role | CEO |
| Phone | 7874330055 |
Taxonomy
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| License Number | ACN804 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CARDONA, CARLOS R | Agent | 505 GREENBROUGH DR, LAKE WALES, FL 33853 |
| Name | Role | Address |
|---|---|---|
| CARDONA, CARLOS R | Manager | 505 GREENBROUGH DR, LAKE WALES, FL 33853 |
| MERCADO, LOURDES | Manager | 505 GREENBROUGH DR, LAKE WALES, FL 33853 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-04-16 |
| ANNUAL REPORT | 2017-05-01 |
| Florida Limited Liability | 2016-07-18 |
Date of last update: 19 Jan 2025
Sources: Florida Department of State
