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PHOENIX INTERNAL MEDICINE LLC - Florida Company Profile

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Company Details

Entity Name: PHOENIX INTERNAL MEDICINE LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 04 Feb 2019 (7 years ago)
Document Number: L19000034571
FEI/EIN Number 83-3625533
Address: 436 Selkirk Drive, WINTER PARK, FL, 32792, US
Mail Address: 127 W FAIRBANKS AVENUE #374, WINTER PARK, FL, 32789, US
ZIP code: 32792
City: Winter Park
County: Orange
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
POWERS ROBERT Authorized Member 127 W FAIRBANKS AVENUE #374, WINTER PARK, FL, 32789
POWERS ROBERT B Agent 127 W FAIRBANKS AVENUE #374, WINTER PARK, FL, 32789

National Provider Identifier

NPI Number:
1558823500
Certification Date:
2020-10-09

Authorized Person:

Name:
ROBERT POWERS
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
208M00000X - Hospitalist Physician
Is Primary:
Yes

Contacts:

Fax:
4076418133

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2023-08-11 436 Selkirk Drive, WINTER PARK, FL 32792 -
CHANGE OF MAILING ADDRESS 2020-02-25 436 Selkirk Drive, WINTER PARK, FL 32792 -
REGISTERED AGENT ADDRESS CHANGED 2020-02-25 127 W FAIRBANKS AVENUE #374, WINTER PARK, FL 32789 -

Documents

Name Date
ANNUAL REPORT 2024-03-25
AMENDED ANNUAL REPORT 2023-08-11
ANNUAL REPORT 2023-02-27
ANNUAL REPORT 2022-08-24
ANNUAL REPORT 2021-05-28
ANNUAL REPORT 2020-02-25
Florida Limited Liability 2019-02-04

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Date of last update: 01 Aug 2025

Sources: Florida Department of State