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  5. CH AFFILIATES, LLC

CH AFFILIATES, LLC

Company Details

Entity Name: CH AFFILIATES, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Company
Status: Active
Date Filed: 23 Mar 2018 (7 years ago)
Last Event: LC AMENDMENT
Event Date Filed: 30 Sep 2019 (5 years ago)
Document Number: L18000075691
FEI/EIN Number 82-4981393
Address: 5833 SOUTH GOLDENROD RD, STE 5-C&D, ORLANDO, FL 32822
Mail Address: 5833 SOUTH GOLDENROD RD, SUITE C, ORLANDO, FL 32822
ZIP code: 32822
County: Orange
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1437644325 2018-06-25 2022-09-14 5833 S GOLDENROD RD STE 5C&D, ORLANDO, FL, 328228777, US 5833 S GOLDENROD RD STE 5C&D, ORLANDO, FL, 328228777, US

Contacts
Phone +1 407-810-8777
Fax 4076580721
Phone +1 843-345-2168

Authorized person
Name DR. WAYNE ELLIS HALL
Role CO-OWNER/PA-C
Phone 8433452168

Taxonomy
Taxonomy Code 261QU0200X - Urgent Care Clinic/Center
State FL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 107787700
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CH AFFILIATES, LLC 401(K) PROFIT SHARING PLAN AND TRUST 2023 824981393 2024-09-27 CH AFFILIATES LLC 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621498
Sponsor’s telephone number 4078108777
Plan sponsor’s address 5833 SOUTH GOLDENROD RD, STE 5, ORLANDO, FL, 32822
CH AFFILIATES, LLC 401(K) PROFIT SHARING PLAN AND TRUST 2022 824981393 2023-10-10 CH AFFILIATES LLC 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621498
Sponsor’s telephone number 4078108777
Plan sponsor’s address 5833 SOUTH GOLDENROD RD, STE 5, ORLANDO, FL, 32822
CH AFFILIATES, LLC 401(K) PROFIT SHARING PLAN AND TRUST 2021 824981393 2023-01-19 CH AFFILIATES LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621498
Sponsor’s telephone number 4078108777
Plan sponsor’s address 5833 SOUTH GOLDENROD RD, STE 5, ORLANDO, FL, 32822
CH AFFILIATES LLC 401(K) PROFIT SHARING PLAN & TRUST 2021 824981393 2022-07-15 CH AFFILIATES LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621498
Sponsor’s telephone number 3528430021
Plan sponsor’s address 5833 SOUTH GOLDENROD RD SUITE 5 CD, ORLANDO, FL, 32822

Signature of
Role Plan administrator
Date 2022-07-15
Name of individual signing GREGORY CROSBY
Valid signature Filed with authorized/valid electronic signature
CH AFFILIATES LLC 401(K) PROFIT SHARING PLAN & TRUST 2020 824981393 2021-06-03 CH AFFILIATES LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621498
Sponsor’s telephone number 3528430021
Plan sponsor’s address 5833 SOUTH GOLDENROD RD STE 5, ORLANDO, FL, 32822

Signature of
Role Plan administrator
Date 2021-06-03
Name of individual signing EDWARD ROJAS
Valid signature Filed with authorized/valid electronic signature
CH AFFILIATES LLC 401(K) PROFIT SHARING PLAN & TRUST 2019 824981393 2020-06-19 CH AFFILIATES LLC 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621498
Sponsor’s telephone number 3528430021
Plan sponsor’s address 5833 SOUTH GOLDENROD RD STE 5, ORLANDO, FL, 32822

Signature of
Role Plan administrator
Date 2020-06-19
Name of individual signing EDWARD ROJAS
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Crosby, Gregory Agent 5833 SOUTH GOLDENROD RD, SUITE C, ORLANDO, FL 32822

Manager

Name Role Address
CROSBY, GREGORY Manager 1788 Burchstone Drive, Orlando, FL 32806
HALL, WAYNE Manager 907 TIMBER ISLE DRIVE, ORLANDO, FL 32828

Authorized Member

Name Role Address
CROSBY, PATRICIA Authorized Member 5681 SE 12TH ST, OCALA, FL 34480
Dub, Larissa Authorized Member 700 W Oak St, Kissimmee, FL 34741

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G22000088293 PRESTIGE URGENT CARE ACTIVE 2022-07-26 2027-12-31 No data 5833 S. GOLDENROD RD, STE 5C&D, ORLANDO, FL, 32822
G18000070612 PARAMOUNT URGENT CARE EXPIRED 2018-06-22 2023-12-31 No data 9161 NARCOOSSEE RD, SUITE 202, ORLANDO, FL, 32827

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2023-04-12 Crosby, Gregory No data
REGISTERED AGENT ADDRESS CHANGED 2023-04-12 5833 SOUTH GOLDENROD RD, SUITE C, ORLANDO, FL 32822 No data
CHANGE OF MAILING ADDRESS 2020-04-30 5833 SOUTH GOLDENROD RD, STE 5-C&D, ORLANDO, FL 32822 No data
LC AMENDMENT 2019-09-30 No data No data
CHANGE OF PRINCIPAL ADDRESS 2018-07-05 5833 SOUTH GOLDENROD RD, STE 5-C&D, ORLANDO, FL 32822 No data

Documents

Name Date
ANNUAL REPORT 2024-04-05
ANNUAL REPORT 2023-04-12
ANNUAL REPORT 2022-04-01
ANNUAL REPORT 2021-04-07
ANNUAL REPORT 2020-04-30
LC Amendment 2019-09-30
ANNUAL REPORT 2019-04-15
Florida Limited Liability 2018-03-23

Related by officers

CROSBY, GREGORY

PERSONAL CONCIERGE, INC. Y L M, INC.

HALL, WAYNE

PARTYTOWERS, LLC CAJUN CONDO LLC SUN BAY TOWNHOME PROJECT LLC PDT FL MU ALUMNI ASSOCIATION, INC. TERICO INVESTMENTS, LLC SUPER KLEAN CLEANING SERVICES, LLC THE W.E. HALL FOUNDATION, INC. HALL TRIBE TRUST LLC CRANBROOK COLONY COMMONS ASSOCIATION, INC. EMS OF ORLANDO, INC.

CROSBY, PATRICIA

DREAM IT WITH MARINELAND INC CRYSTAL CLEAN, INC.

Related by address

No related companies by address

Date of last update: 18 Jan 2025

Sources: Florida Department of State

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