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LLYON MEDICAL, LLC - Florida Company Profile

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Company Details

Entity Name: LLYON MEDICAL, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
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, US
Mail Address: 135 Waterview Cove Drive, Freeport, FL, 32439, US
ZIP code: 32439
City: Freeport
County: Walton
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
Roberts Tim Authorized Member 135 Waterview Cove Drive, Freeport, FL, 32439
SIMS ERNEST Agent 151 REGIONS WAY, DESTIN, FL, 32541

National Provider Identifier

NPI Number:
1447070826
Certification Date:
2024-10-11

Authorized Person:

Name:
TIM MARCUS ROBERTS
Role:
EXECUTIVE DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
Yes

Contacts:

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2022-03-23 135 Waterview Cove Drive, Freeport, FL 32439 -
CHANGE OF MAILING ADDRESS 2022-03-23 135 Waterview Cove Drive, Freeport, FL 32439 -

Documents

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

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Date of last update: 01 Aug 2025

Sources: Florida Department of State