| Entity Name: | BOUTIQ MEDICAL CLINIC LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Company
BOUTIQ MEDICAL CLINIC LLC 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: | 02 Dec 2019 (5 years ago) |
| Document Number: | L19000293784 |
| FEI/EIN Number |
84-3846526
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 817 VIRGINIA DRIVE, ORLANDO, FL 32803 |
| Mail Address: | 1815 GERDA TERRACE, ORLANDO, FL 32804 |
| ZIP code: | 32803 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1558947499 | 2021-03-22 | 2021-04-07 | 1815 GERDA TER, ORLANDO, FL, 328045934, US | 1430 N MILLS AVE STE 120, ORLANDO, FL, 328031877, US | |||||||||||||||||||
|
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| Phone | +1 407-446-5425 |
| Phone | +1 407-777-2449 |
Authorized person
| Name | MS. KAREN L BUCKALEW |
| Role | PRESIDENT/OWNER |
| Phone | 4077772449 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| THORPES CONSULTING SYSTEMS INC | Agent | 7345 W SAND LAKE ROAD, 306, ORLANDO, FL 32819 |
| BUCKALEW, KAREN | President | 1815 GERDA TERRACE, ORLANDO, FL 32804 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-27 | 817 VIRGINIA DRIVE, ORLANDO, FL 32803 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2021-02-20 | 7345 W SAND LAKE ROAD, 306, ORLANDO, FL 32819 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-27 |
| ANNUAL REPORT | 2023-03-31 |
| ANNUAL REPORT | 2022-04-27 |
| ANNUAL REPORT | 2021-02-20 |
| Florida Limited Liability | 2019-12-02 |
Date of last update: 15 Feb 2025
Sources: Florida Department of State
