| Entity Name: | HORIZON FAMILY MEDICAL PRACTICE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 06 Mar 2019 (6 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 16 Nov 2020 (4 years ago) |
| Document Number: | L19000056608 |
| FEI/EIN Number | 83-3945925 |
| Address: | 1236 ROYAL PALM BEACH BLVD, ROYAL PALM BEACH, FL, 33411, US |
| Mail Address: | 1236 ROYAL PALM BEACH BLVD, ROYAL PALM BEACH, FL, 33411, US |
| ZIP code: | 33411 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1134740061 | 2020-05-01 | 2020-05-07 | 1236 ROYAL PALM BEACH BLVD STE 108, ROYAL PALM BEACH, FL, 334111602, US | 1236 ROYAL PALM BEACH BLVD STE 108, ROYAL PALM BEACH, FL, 334111602, US | |||||||||||||||||||||
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| Phone | +1 561-774-8660 |
| Fax | 5617748660 |
| Fax | 5617748665 |
Authorized person
| Name | VALEREY BARTHELEMY |
| Role | CREDENTIAL MANAGER |
| Phone | 5617748660 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| CHANG MERREL | Agent | 1236 ROYAL PALM BEACH BLVD, ROYAL PALM BEACH, FL, 33411 |
| Name | Role | Address |
|---|---|---|
| CHANG MERREL | Manager | 1236 ROYAL PALM BEACH BLVD, ROYAL PALM BEACH, FL, 33411 |
| JAMES LECIA | Manager | 1236 ROYAL PALM BEACH BLVD, ROYAL PALM BEACH, FL, 33411 |
| WEST BEVERLEY | Manager | 1236 ROYAL PALM BEACH BLVD, ROYAL PALM BEACH, FL, 33411 |
| PERRIN ANTHONY | Manager | 1236 ROYAL PALM BEACH BLVD, ROYAL PALM BEACH, FL, 33411 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2020-11-16 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-11-16 | 1236 ROYAL PALM BEACH BLVD, ROYAL PALM BEACH, FL 33411 | No data |
| CHANGE OF MAILING ADDRESS | 2020-11-16 | 1236 ROYAL PALM BEACH BLVD, ROYAL PALM BEACH, FL 33411 | No data |
| REGISTERED AGENT NAME CHANGED | 2020-11-16 | CHANG, MERREL | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-11-16 | 1236 ROYAL PALM BEACH BLVD, ROYAL PALM BEACH, FL 33411 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-04-26 |
| ANNUAL REPORT | 2022-03-31 |
| ANNUAL REPORT | 2021-04-30 |
| LC Amendment | 2020-11-16 |
| ANNUAL REPORT | 2020-05-05 |
| Florida Limited Liability | 2019-03-06 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
