| Entity Name: | FAMILIA HEALTH CLINIC LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 23 May 2019 (6 years ago) |
| Document Number: | L19000139377 |
| FEI/EIN Number | 84-2005821 |
| Address: | 450 W HILLSBORO BLVD, DEERFIELD BEACH, FL 33441 |
| Mail Address: | 450 W HILLSBORO BLVD, DEERFIELD BEACH, FL 33441 |
| ZIP code: | 33441 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1164035861 | 2020-08-24 | 2022-11-10 | 450 W HILLSBORO BLVD, DEERFIELD BEACH, FL, 334411604, US | 450 W HILLSBORO BLVD, DEERFIELD BEACH, FL, 334411604, US | |||||||||||||||||||||
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| Phone | +1 954-531-0461 |
| Fax | 9545310713 |
Authorized person
| Name | ARTHUR SODERBERG |
| Role | CFO |
| Phone | 9545310461 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | AHCA LICENSE |
| Number | 12398 |
| State | FL |
| Name | Role |
|---|---|
| CSG - CAPITAL SERVICES GROUP, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| PARAMOUNT HOLDING INTERNATIONAL LLC | Authorized Member | 450 W HILLSBORO BLVD, DEERFIELD BEACH, FL 33441 |
| Name | Role | Address |
|---|---|---|
| SODERBERG, TOMAS EDVARD RUNE | MANAGER | 450 W HILLSBORO BLVD, DEERFIELD BEACH, FL 33441 |
| SODERBERG, ANA RITA FEHR | MANAGER | 450 W HILLSBORO BLVD, DEERFIELD BEACH, FL 33441 |
| Name | Role | Address |
|---|---|---|
| SODERBERG, ARTHUR FEHR | Manager | 450 W HILLSBORO BLVD, DEERFIELD BEACH, FL 33441 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-09-20 | 450 W HILLSBORO BLVD, DEERFIELD BEACH, FL 33441 | No data |
| CHANGE OF MAILING ADDRESS | 2022-09-20 | 450 W HILLSBORO BLVD, DEERFIELD BEACH, FL 33441 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-01-13 | 1191 E NEWPORT CENTER DR, Suite 103, DEERFIELD BEACH, FL 33442 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-07-21 |
| ANNUAL REPORT | 2022-04-29 |
| ANNUAL REPORT | 2021-03-30 |
| AMENDED ANNUAL REPORT | 2020-08-25 |
| ANNUAL REPORT | 2020-01-13 |
| Florida Limited Liability | 2019-05-23 |
Date of last update: 17 Jan 2025
Sources: Florida Department of State
