| Entity Name: | LEWIS FAMILY PSYCHIATRY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 13 Dec 2019 (5 years ago) |
| Document Number: | L19000299581 |
| FEI/EIN Number | 84-3994069 |
| Address: | 2646 DANFORTH TERRACE, WELLINGTON, FL, 33414 |
| Mail Address: | 2646 DANFORTH TERRACE, WELLINGTON, FL, 33414 |
| ZIP code: | 33414 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1275172892 | 2019-12-30 | 2019-12-30 | 2646 DANFORTH TER, WELLINGTON, FL, 334143433, US | 12200 FOREST HILL BLVD, WELLINGTON, FL, 334145795, US | |||||||||||||||
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| Phone | +1 561-303-0433 |
| Fax | 5613030433 |
Authorized person
| Name | SARA ANN LEWIS |
| Role | PROVIDER OWNER |
| Phone | 5613030433 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| LEGALINC CORPORATE SERVICES INC. | Agent |
| Name | Role | Address |
|---|---|---|
| LEWIS SARA A | Manager | 2646 DANFORTH TERRACE, WELLINGTON, FL, 33414 |
| LEWIS WILLIAM G | Manager | 2646 DANFORTH TERRACE, WELLINGTON, FL, 33414 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2022-10-10 | 476 RIVERSIDE AVE., JACKSONVILLE, FL 32202 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-20 |
| ANNUAL REPORT | 2023-03-10 |
| ANNUAL REPORT | 2022-03-18 |
| ANNUAL REPORT | 2021-04-28 |
| ANNUAL REPORT | 2020-04-23 |
| Florida Limited Liability | 2019-12-13 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
