| Entity Name: | UNITY MEDICAL CENTER AND SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 09 Feb 2021 (4 years ago) |
| Date of dissolution: | 23 Sep 2022 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (2 years ago) |
| Document Number: | L21000068765 |
| FEI/EIN Number | 862778626 |
| Address: | 6388 SILVER STAR ROAD, ORLANDO, FL, 32818, US |
| Mail Address: | 2543 SUMMER GLEN DR, ORLANDO, FL, 32818, US |
| ZIP code: | 32818 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1801479878 | 2021-04-28 | 2021-05-10 | 2543 SUMMER GLEN DR, ORLANDO, FL, 328184753, US | 1511 PROSPERITY FARMS RD, LAKE PARK, FL, 334032046, US | |||||||||||||||||||||||||||||||
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| Phone | +1 561-410-4501 |
| Phone | +1 508-345-2365 |
Authorized person
| Name | NATACHA ETIENNE |
| Role | VICE PRESIDENT |
| Phone | 5614104501 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | INDIVIDUAL NPI FOR MEDICAL DIRECTOR JOEL PELISSIER |
| Number | 1730454323 |
| State | FL |
| Issuer | MEDICAID |
| Number | 1730454323 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ETIENNE PATRICK | Agent | 2543 SUMMER GLEN DR, ORLANDO, FL, 32818 |
| Name | Role | Address |
|---|---|---|
| ETIENNE PATRICK | President | 2543 SUMMER GLEN DR, ORLANDO, FL, 32818 |
| Name | Role | Address |
|---|---|---|
| ETIENNE NATACHA | Vice President | 1706 CARRIAGE BROOKE DRIVE, WELLINGTON, FL, 33414 |
| Name | Role | Address |
|---|---|---|
| PELISSIER JOEL | Director | 10268 GULFSTONE COURT, FORT MYERS, FL, 33913 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-08-30 | 6388 SILVER STAR ROAD, ORLANDO, FL 32818 | No data |
| Name | Date |
|---|---|
| Florida Limited Liability | 2021-02-09 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
