| Entity Name: | LEVMED LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 09 Nov 2017 (7 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 01 Oct 2018 (6 years ago) |
| Document Number: | L17000232066 |
| FEI/EIN Number | 82-3409105 |
| Address: | 1519 Dr. MLK Jr. St. N, Saint Petersburg, FL, 33704, US |
| Mail Address: | 1519 Dr. MLK Jr. St. N, Saint Petersburg, FL, 33704, US |
| ZIP code: | 33704 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1356829113 | 2018-08-03 | 2018-08-03 | 1519 DR MARTIN LUTHER KING JR ST N, SAINT PETERSBURG, FL, 337044201, US | 1519 DR MARTIN LUTHER KING JR ST N, SAINT PETERSBURG, FL, 337044201, US | |||||||||||||||||||||||||
|
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| Phone | +1 727-314-6472 |
| Fax | 7276192310 |
Authorized person
| Name | DR. BRETT STEPHEN LEVINE |
| Role | PHYSICIAN/OWNER |
| Phone | 7273146472 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | OS12495 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 012768800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LEVINE BRETT SDR. | Agent | 1519 Dr. MLK Jr. St. N, Saint Petersburg, FL, 33704 |
| Name | Role | Address |
|---|---|---|
| LEVINE BRETT SDR. | Manager | 1519 Dr. MLK Jr. St. N, Saint Petersburg, FL, 33704 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2018-10-01 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-10-01 | 1519 Dr. MLK Jr. St. N, Saint Petersburg, FL 33704 | No data |
| CHANGE OF MAILING ADDRESS | 2018-10-01 | 1519 Dr. MLK Jr. St. N, Saint Petersburg, FL 33704 | No data |
| REGISTERED AGENT NAME CHANGED | 2018-10-01 | LEVINE, BRETT S, DR. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-10-01 | 1519 Dr. MLK Jr. St. N, Saint Petersburg, FL 33704 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-14 |
| ANNUAL REPORT | 2023-03-08 |
| ANNUAL REPORT | 2022-01-12 |
| ANNUAL REPORT | 2021-02-08 |
| ANNUAL REPORT | 2020-01-28 |
| ANNUAL REPORT | 2019-02-03 |
| REINSTATEMENT | 2018-10-01 |
| Florida Limited Liability | 2017-11-09 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
