| Entity Name: | FAMILY UNIVERSAL MEDICAL CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 22 Jul 2020 (5 years ago) |
| Date of dissolution: | 21 Sep 2022 (2 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 21 Sep 2022 (2 years ago) |
| Document Number: | L20000215051 |
| FEI/EIN Number | 861244631 |
| Address: | 4531 DeLeon St, FORT MYERS, FL, 33907, US |
| Mail Address: | 4531 DeLeon St, FORT MYERS, FL, 33907, US |
| ZIP code: | 33907 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881289387 | 2021-03-05 | 2021-03-05 | 4531 DELEON ST STE 207, FORT MYERS, FL, 339071280, US | 4531 DELEON ST STE 207, FORT MYERS, FL, 339071280, US | |||||||||||||||
|
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| Phone | +1 239-220-5115 |
| Fax | 2392012601 |
Authorized person
| Name | DR. OTNIEL HERNANDEZ |
| Role | CEO |
| Phone | 3058334707 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| HERNANDEZ OTNIEL Dr. | Agent | 4531 DeLeon St, FORT MYERS, FL, 33907 |
| Name | Role | Address |
|---|---|---|
| CABRERA LAZARO | Vice President | 4531 DeLeon St, FORT MYERS, FL, 33907 |
| Name | Role | Address |
|---|---|---|
| Hernandez Otniel Dr. | Chief Executive Officer | 4531 DeLeon St, FORT MYERS, FL, 33907 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2022-09-21 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-03-01 | 4531 DeLeon St, Suite 207, FORT MYERS, FL 33907 | No data |
| CHANGE OF MAILING ADDRESS | 2021-03-01 | 4531 DeLeon St, Suite 207, FORT MYERS, FL 33907 | No data |
| REGISTERED AGENT NAME CHANGED | 2021-03-01 | HERNANDEZ, OTNIEL, Dr. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-03-01 | 4531 DeLeon St, Suite 207, FORT MYERS, FL 33907 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2022-09-21 |
| ANNUAL REPORT | 2022-01-31 |
| ANNUAL REPORT | 2021-03-01 |
| Florida Limited Liability | 2020-07-22 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
