| Entity Name: | BLACK STALLION WALK-IN AND EXERCISE MEDICINE CLINICS LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 01 Nov 2019 (5 years ago) |
| Date of dissolution: | 04 Dec 2023 (a year ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 04 Dec 2023 (a year ago) |
| Document Number: | L19000273476 |
| FEI/EIN Number | 84-3731865 |
| Address: | 9955 SE Federal Hwy, Hobe Sound, FL, 33455, US |
| Mail Address: | 9955 SE Federal Hwy, Hobe Sound, FL, 33455, US |
| ZIP code: | 33455 |
| County: | Martin |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1720607484 | 2020-04-13 | 2020-04-13 | 9955 SE FEDERAL HWY, HOBE SOUND, FL, 334554829, US | 9955 SE FEDERAL HWY, HOBE SOUND, FL, 334554829, US | |||||||||||||||||||
|
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| Phone | +1 772-932-9310 |
Authorized person
| Name | GRACIA PIERRE-PIERRE |
| Role | OWNER |
| Phone | 7729329310 |
Taxonomy
| Taxonomy Code | 207QS0010X - Sports Medicine (Family Medicine) Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | CAQH |
| Number | 13595686 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PIERRE-CANEL ALAND | Agent | 12790 W. DIXIE HWY, N. MIAMI,, FL, 33161 |
| Name | Role | Address |
|---|---|---|
| PIERRE-PIERRE GRACIA M | Manager | 4975 NW FITZGERALD AVE, PORT ST. LUCIE, FL, 34983 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000146558 | HOBE SOUND PRIMARY CARE | ACTIVE | 2020-11-14 | 2025-12-31 | No data | 9955 SE FEDERAL HWY, HOBE SOUND, FL, 33455 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2023-12-04 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-01-29 | 9955 SE Federal Hwy, B, Hobe Sound, FL 33455 | No data |
| CHANGE OF MAILING ADDRESS | 2022-01-29 | 9955 SE Federal Hwy, B, Hobe Sound, FL 33455 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2023-12-04 |
| ANNUAL REPORT | 2023-01-24 |
| ANNUAL REPORT | 2022-01-29 |
| ANNUAL REPORT | 2021-02-03 |
| ANNUAL REPORT | 2020-01-19 |
| Florida Limited Liability | 2019-11-01 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
