| Entity Name: | PAN AMERICAN MEDICAL GROUP LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 15 Dec 2016 (8 years ago) |
| Document Number: | L16000226956 |
| FEI/EIN Number | 81-4708470 |
| Address: | 7359 Lake Underhill Road, ORLANDO, FL, 32822, US |
| Mail Address: | 7359 Lake Underhill Road, ORLANDO, FL, 32822, US |
| ZIP code: | 32822 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1356866354 | 2017-08-10 | 2024-10-31 | 11217 HISTORY AVE, ORLANDO, FL, 328325210, US | 7359 LAKE UNDERHILL RD, ORLANDO, FL, 328226061, US | |||||||||||||||||
|
|||||||||||||||||||||
| Phone | +1 956-832-2053 |
| Fax | 4072038887 |
| Phone | +1 407-900-9284 |
Authorized person
| Name | DR. JUAN CARLOS CANTU |
| Role | MEDICAL DIRECTOR |
| Phone | 4079009284 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CANTU JUAN CMD | Agent | 11217 HISTORY AVE, ORLANDO, FL, 32832 |
| Name | Role | Address |
|---|---|---|
| Cantu Juan CMD | Authorized Member | 11217 HISTORY AVE, ORLANDO, FL, 32832 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-29 | 7359 Lake Underhill Road, ORLANDO, FL 32822 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-29 | 7359 Lake Underhill Road, ORLANDO, FL 32822 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-04-28 | 11217 HISTORY AVE, ORLANDO, FL 32832 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-11 |
| ANNUAL REPORT | 2023-04-20 |
| ANNUAL REPORT | 2022-06-01 |
| ANNUAL REPORT | 2021-04-28 |
| ANNUAL REPORT | 2020-04-30 |
| ANNUAL REPORT | 2019-04-28 |
| ANNUAL REPORT | 2018-04-26 |
| Florida Limited Liability | 2016-12-15 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
