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GENESIS GROUP OF FAMILY PRACTICES LLC - Florida Company Profile

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Company Details

Entity Name: GENESIS GROUP OF FAMILY PRACTICES LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 09 May 2017 (8 years ago)
Document Number: L17000102998
FEI/EIN Number 46-1045369
Address: 800 S NOVA RD, J, ORMOND BEACH, FL, 32763, US
Mail Address: 1133 SAXON BLVD, 200, ORANGE CITY, FL, 32763, US
ZIP code: 32763
City: Orange City
County: Volusia
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
CHANMUGAM JAY Manager 1133 SAXON BLVD STE 200, ORANGE CITY, FL, FL, 32763
CHANMUGAM JAY C Agent 1133 SAXON BLVD, ORANGE CITY, FL, 32763

National Provider Identifier

NPI Number:
1215464094

Authorized Person:

Name:
JAY C CHANMUGAM
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
208D00000X - General Practice Physician
Is Primary:
Yes

Contacts:

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2018-04-23 800 S NOVA RD, J, ORMOND BEACH, FL 32763 -

Documents

Name Date
ANNUAL REPORT 2024-02-07
ANNUAL REPORT 2023-02-02
ANNUAL REPORT 2022-02-24
ANNUAL REPORT 2021-01-13
ANNUAL REPORT 2020-03-24
ANNUAL REPORT 2019-04-25
ANNUAL REPORT 2018-04-23
Florida Limited Liability 2017-05-09

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Date of last update: 03 Aug 2025

Sources: Florida Department of State