| Entity Name: | IO MEDICAL, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 18 Mar 2019 (6 years ago) |
| Document Number: | L19000075314 |
| FEI/EIN Number | 83-4453531 |
| Address: | 320 N. EDINBURGH DRIVE, SUITE B, WINTER PARK, FL 32792 |
| Mail Address: | 320 N. EDINBURGH DRIVE, SUITE B, WINTER PARK, FL 32792 |
| ZIP code: | 32792 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1104475466 | 2019-09-10 | 2023-03-16 | 320 N EDINBURGH DR STE B, WINTER PARK, FL, 327924157, US | 320 N EDINBURGH DR STE B, WINTER PARK, FL, 327924157, US | |||||||||||||||||||||
|
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| Phone | +1 407-951-5348 |
| Fax | 3219725967 |
Authorized person
| Name | RAQUEL MICHEL |
| Role | OWNER |
| Phone | 4079515348 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 005452900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Aquino , Dioben | Agent | 320 N. EDINBURGH DRIVE, SUITE B, WINTER PARK, FL 32792 |
| Name | Role | Address |
|---|---|---|
| MICHEL, RAQUEL | Authorized Member | 320 N. EDINBURGH DRIVE, SUITE B WINTER PARK, FL 32792 |
| Name | Role | Address |
|---|---|---|
| Aquino, Dioben | President | 320 N. EDINBURGH DRIVE, SUITE B WINTER PARK, FL 32792 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-02-06 | Aquino , Dioben | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-06 | 320 N. EDINBURGH DRIVE, SUITE B, WINTER PARK, FL 32792 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-03-24 | 320 N. EDINBURGH DRIVE, SUITE B, WINTER PARK, FL 32792 | No data |
| CHANGE OF MAILING ADDRESS | 2022-03-24 | 320 N. EDINBURGH DRIVE, SUITE B, WINTER PARK, FL 32792 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-02-10 |
| ANNUAL REPORT | 2024-02-06 |
| ANNUAL REPORT | 2023-01-17 |
| ANNUAL REPORT | 2022-03-24 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-06-26 |
| Florida Limited Liability | 2019-03-18 |
Date of last update: 16 Feb 2025
Sources: Florida Department of State
