| Entity Name: | IMPACT 13 MEDICAL, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
IMPACT 13 MEDICAL, PLLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 21 Aug 2019 (6 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 04 Oct 2022 (3 years ago) |
| Document Number: | L19000214345 |
| FEI/EIN Number |
84-3287646
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 7755 La Mirada Drive, Boca Raton, FL, 33433, US |
| Mail Address: | 7755 La Mirada Drive, Boca Raton, FL, 33433, US |
| ZIP code: | 33433 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548805617 | 2019-11-13 | 2019-12-18 | 10752 DEERWOOD PARK BLVD, SOUTH WATERVIEW II SUITE 100, JACKSONVILLE, FL, 322568666, US | 10752 DEERWOOD PARK BLVD, SOUTH WATERVIEW II SUITE 100, JACKSONVILLE, FL, 32256, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 904-755-1017 |
| Fax | 6467740386 |
Authorized person
| Name | DR. WIL E GERMAIN |
| Role | OWNER |
| Phone | 5164121608 |
Taxonomy
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| Is Primary | No |
| Taxonomy Code | 2084N0400X - Neurology Physician |
| Is Primary | Yes |
| Taxonomy Code | 2084P0804X - Child & Adolescent Psychiatry Physician |
| Is Primary | No |
| Taxonomy Code | 2084P0805X - Geriatric Psychiatry Physician |
| Is Primary | No |
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| Germain Wil E | Owne | 7755 La Mirada Drive, Boca Raton, FL, 33433 |
| Germain Wil E | Agent | 7755 La Mirada Drive, Boca Raton, FL, 33433 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-06-29 | 7755 La Mirada Drive, Boca Raton, FL 33433 | - |
| CHANGE OF MAILING ADDRESS | 2023-06-29 | 7755 La Mirada Drive, Boca Raton, FL 33433 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2023-06-29 | 7755 La Mirada Drive, Boca Raton, FL 33433 | - |
| REINSTATEMENT | 2022-10-04 | - | - |
| REGISTERED AGENT NAME CHANGED | 2022-10-04 | Germain, Wil E | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | - | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-08-01 |
| ANNUAL REPORT | 2023-06-29 |
| REINSTATEMENT | 2022-10-04 |
| ANNUAL REPORT | 2021-08-04 |
| ANNUAL REPORT | 2020-02-06 |
| Florida Limited Liability | 2019-08-21 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
