| Entity Name: | DESROCHES MEDICAL CLINIC LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 26 Jun 2019 (6 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 24 Jan 2022 (3 years ago) |
| Document Number: | L19000167255 |
| FEI/EIN Number | 84-2457955 |
| Address: | 7500 West Commercial Boulevard, Tamarac, FL 33319 |
| Mail Address: | 422 South Scott Avenue, Sanford, FL 32771 |
| ZIP code: | 33319 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1720625775 | 2019-12-09 | 2023-03-07 | 10071 MONTAGUE ST, TAMPA, FL, 336261855, US | 10071 MONTAGUE ST, TAMPA, FL, 336263362, US | |||||||||||||
|
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| Phone | +1 321-208-2390 |
Authorized person
| Name | DANIELLE DESROCHES |
| Role | APRN |
| Phone | 3212082390 |
Taxonomy
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DESROCHES, DANIELLE | Agent | 10071 MONTAGUE STREET, TAMPA, FL 33626 |
| Name | Role | Address |
|---|---|---|
| DESROCHES, DANIELLE | President and CEO | 444 South Scott Avenue, Sanford, FL 32771 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-31 | 7500 West Commercial Boulevard, Tamarac, FL 33319 | No data |
| CHANGE OF MAILING ADDRESS | 2024-03-31 | 7500 West Commercial Boulevard, Tamarac, FL 33319 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-03-31 | 10071 MONTAGUE STREET, TAMPA, FL 33626 | No data |
| REINSTATEMENT | 2022-01-24 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2022-01-24 | DESROCHES, DANIELLE | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-02-13 |
| ANNUAL REPORT | 2024-03-31 |
| ANNUAL REPORT | 2023-01-24 |
| REINSTATEMENT | 2022-01-24 |
| Florida Limited Liability | 2019-06-26 |
Date of last update: 16 Feb 2025
Sources: Florida Department of State
