| Entity Name: | LIBERTY MEDICAL SUPPLY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 12 May 2020 (5 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year ago) |
| Document Number: | L20000128172 |
| FEI/EIN Number | 85-1115328 |
| Address: | 1700 N Dixie Highway, #116, Boca Raton, FL 33432 |
| Mail Address: | 1700 N Dixie Highway, #116, Boca Raton, FL 33432 |
| ZIP code: | 33432 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1194337683 | 2020-08-18 | 2022-04-28 | 1700 N DIXIE HWY STE 116, BOCA RATON, FL, 334321807, US | 1700 N DIXIE HWY STE 116, BOCA RATON, FL, 334321807, US | |||||||||||||
|
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| Phone | +1 844-397-5011 |
Authorized person
| Name | IVAN ASHLEY FERGUSON |
| Role | OWNER |
| Phone | 8443975011 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LIBERTY MEDICAL SUPPLY HEALTH & WELFARE PLAN | 2014 | 650193983 | 2015-07-22 | LIBERTY MEDICAL SUPPLY | 504 | |||||||||||||||||||||||||||||||||||||||||||||||
|
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| Active participants | 452 |
| Retired or separated participants receiving benefits | 0 |
| Other retired or separated participants entitled to future benefits | 0 |
| Deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 0 |
| Number of participants with account balances as of the end of the plan year | 0 |
| Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 0 |
Signature of
| Role | Plan administrator |
| Date | 2015-07-22 |
| Name of individual signing | DANIELLE VELTRE |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2015-07-22 |
| Name of individual signing | DANIELLE VELTRE |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| FERGUSON, IVAN | Agent | 1700 N DIXIE HWY #116, BOCA RATON, FL 33431 |
| Name | Role | Address |
|---|---|---|
| FERGUSON, IVAN | Authorized Member | 1700 N DIXIE HWY #116, BOCA RATON, FL 33431 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-05-16 | 1700 N Dixie Highway, #116, Boca Raton, FL 33432 | No data |
| CHANGE OF MAILING ADDRESS | 2022-05-16 | 1700 N Dixie Highway, #116, Boca Raton, FL 33432 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-04-15 | 1700 N DIXIE HWY #116, BOCA RATON, FL 33431 | No data |
| LC AMENDMENT | 2022-04-15 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2022-04-15 | FERGUSON, IVAN | No data |
| LC AMENDMENT | 2021-01-07 | No data | No data |
| LC AMENDMENT | 2020-08-04 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J23000081935 | ACTIVE | 502022CC015160 | 15TH JUD CIR | 2023-02-20 | 2028-02-28 | $6,084.52 | MIZNER CITY INVESTMENTS LLC, 215 N FEDERAL HWY, BOCA RATON, FL 33432 |
| Name | Date |
|---|---|
| LC Amendment | 2022-04-15 |
| ANNUAL REPORT | 2022-01-27 |
| ANNUAL REPORT | 2021-02-02 |
| LC Amendment | 2021-01-07 |
| LC Amendment | 2020-08-04 |
| Florida Limited Liability | 2020-05-12 |
Date of last update: 16 Jan 2025
Sources: Florida Department of State
