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PHYSICIANS OF HOLLYWOOD, LLC

Company Details

Entity Name: PHYSICIANS OF HOLLYWOOD, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Company
Status: Active
Date Filed: 17 Mar 2020 (5 years ago)
Last Event: LC AMENDMENT
Event Date Filed: 14 Sep 2020 (4 years ago)
Document Number: L20000078479
FEI/EIN Number 84-5134458
Address: 7900 NOVA DRIVE SUITE 103, DAVIE, FL 33324
Mail Address: 7900 NOVA DRIVE SUITE 103, DAVIE, FL 33324
ZIP code: 33324
County: Broward
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1144856626 2020-03-17 2020-03-17 5201 HOLLYWOOD BLVD, HOLLYWOOD, FL, 330216422, US 5201 HOLLYWOOD BLVD, HOLLYWOOD, FL, 330216422, US

Contacts

Phone +1 954-716-9114

Authorized person

Name MRS. ILEANA A VILA
Role MEDICAL DOCTOR
Phone 9547169114

Taxonomy

Taxonomy Code 261Q00000X - Clinic/Center
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PHYSICIANS OF HOLLYWOOD, LLC 401(K) PROFIT SHARING PLAN & TRUST 2023 845134458 2024-04-05 PHYSICIANS OF HOLLYWOOD LLC 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621491
Sponsor’s telephone number 6315231094
Plan sponsor’s address 5201 HOLLYWOOD BLVD, STE 2, HOLLYWOOD, FL, 33021

Signature of

Role Plan administrator
Date 2024-04-05
Name of individual signing JOHN CALLEGARI
Valid signature Filed with authorized/valid electronic signature
PHYSICIANS OF HOLLYWOOD, LLC 401(K) PROFIT SHARING PLAN & TRUST 2023 845134458 2024-04-23 PHYSICIANS OF HOLLYWOOD, LLC 34
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621491
Sponsor’s telephone number 6315231094
Plan sponsor’s address 5201 HOLLYWOOD BLVD, STE 2, HOLLYWOOD, FL, 33021

Signature of

Role Plan administrator
Date 2024-04-23
Name of individual signing JOHN CALLEGARI
Valid signature Filed with authorized/valid electronic signature
PHYSICIANS OF HOLLYWOOD, LLC 401(K) PROFIT SHARING PLAN & TRUST 2022 845134458 2023-04-04 PHYSICIANS OF HOLLYWOOD LLC 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621491
Sponsor’s telephone number 6315231094
Plan sponsor’s address 5201 HOLLYWOOD BLVD, STE 2, HOLLYWOOD, FL, 33021

Signature of

Role Plan administrator
Date 2023-04-04
Name of individual signing JOHN CALLEGARI
Valid signature Filed with authorized/valid electronic signature
PHYSICIANS OF HOLLYWOOD, LLC 401(K) PROFIT SHARING PLAN & TRUST 2021 845134458 2022-05-24 PHYSICIANS OF HOLLYWOOD LLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621491
Sponsor’s telephone number 6315231094
Plan sponsor’s address 5201 HOLLYWOOD BLVD, STE 2, HOLLYWOOD, FL, 33021

Signature of

Role Plan administrator
Date 2022-05-24
Name of individual signing JOHN CALLEGARI
Valid signature Filed with authorized/valid electronic signature
PHYSICIANS OF HOLLYWOOD, LLC 401(K) PROFIT SHARING PLAN & TRUST 2020 845134458 2021-06-03 PHYSICIANS OF HOLLYWOOD LLC 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621491
Sponsor’s telephone number 6315231094
Plan sponsor’s address 5201 HOLLYWOOD BLVD, STE 2, HOLLYWOOD, FL, 33021

Signature of

Role Plan administrator
Date 2021-06-03
Name of individual signing JOHN CALLEGARI
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
GBBPL REGISTERED AGENTS, LLC Agent 901 PONCE DE LEON BLVD SUITE 303, CORAL GABLES, FL 33134

Manager

Name Role Address
VAZQUEZ, BALBINO Manager 5201 HOLLYWOOD BLVD, STE 2 HOLLYWOOD, FL 33021

President

Name Role Address
Gonzalez, Manuel of President 5201 HOLLYWOOD BLVD FL 2FL-1, Hollywood, FL 33021

Chief Financial Officer

Name Role Address
Callegari, John of Chief Financial Officer 5201 HOLLYWOOD BLVD FL 2FL-1, Hollywood, FL 33021

Events

Event Type Filed Date Value Description
LC AMENDMENT 2020-09-14 No data No data

Documents

Name Date
AMENDED ANNUAL REPORT 2024-01-30
ANNUAL REPORT 2024-01-29
ANNUAL REPORT 2023-02-01
ANNUAL REPORT 2022-04-29
ANNUAL REPORT 2021-04-28
LC Amendment 2020-09-14
Florida Limited Liability 2020-03-17

Date of last update: 16 Jan 2025

Sources: Florida Department of State