| Entity Name: | LLYON MEDICAL, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 11 Jun 2019 (6 years ago) |
| Document Number: | L19000155053 |
| FEI/EIN Number | 84-2223009 |
| Address: | 135 Waterview Cove Drive, Freeport, FL 32439 |
| Mail Address: | 135 Waterview Cove Drive, Freeport, FL 32439 |
| ZIP code: | 32439 |
| County: | Walton |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1447070826 | 2024-10-11 | 2024-10-11 | 135 WATERVIEW COVE DR, FREEPORT, FL, 324392810, US | 5205 GREENWOOD AVE STE 213, WEST PALM BEACH, FL, 334072400, US | |||||||||||||||
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| Phone | +1 850-687-6618 |
| Phone | +1 561-203-9747 |
Authorized person
| Name | TIM MARCUS ROBERTS |
| Role | EXECUTIVE DIRECTOR |
| Phone | 8506876618 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SIMS, ERNEST | Agent | 151 REGIONS WAY, 6B, DESTIN, FL 32541 |
| Name | Role | Address |
|---|---|---|
| Roberts, Tim | Authorized Member | 135 Waterview Cove Drive, Freeport, FL 32439 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-03-23 | 135 Waterview Cove Drive, Freeport, FL 32439 | No data |
| CHANGE OF MAILING ADDRESS | 2022-03-23 | 135 Waterview Cove Drive, Freeport, FL 32439 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-11 |
| ANNUAL REPORT | 2023-01-20 |
| ANNUAL REPORT | 2022-03-23 |
| ANNUAL REPORT | 2021-02-02 |
| ANNUAL REPORT | 2020-06-30 |
| Florida Limited Liability | 2019-06-11 |
Date of last update: 16 Jan 2025
Sources: Florida Department of State
