| Entity Name: | DAWSON INTEGRATIVE MEDICAL CENTER LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 17 Mar 2021 (4 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 17 May 2021 (4 years ago) |
| Document Number: | L21000126106 |
| FEI/EIN Number | 862495331 |
| Address: | 10244 East Colonial Drive, Suite 204, ORLANDO, FL, 32817, US |
| Mail Address: | 10244 East Colonial Drive, Suite 204, ORLANDO, FL, 32817, US |
| ZIP code: | 32817 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1679152979 | 2021-04-05 | 2024-11-07 | 10244 E COLONIAL DR STE 204, ORLANDO, FL, 328174338, US | 10244 E COLONIAL DR STE 204, ORLANDO, FL, 328174338, US | |||||||||||||||||||||||||||||||||||
|
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| Phone | +1 407-777-2673 |
| Fax | 4076122226 |
Authorized person
| Name | CHRISTINA MARIE DAWSON |
| Role | PHYSICIAN OWNER |
| Phone | 4074856199 |
Taxonomy
| Taxonomy Code | 171100000X - Acupuncturist |
| Is Primary | No |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | No |
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
| Taxonomy Code | 363LP2300X - Primary Care Nurse Practitioner |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| Dawson Christina MDr. | Agent | 10244 East Colonial Drive, ORLANDO, FL, 32817 |
| Name | Role | Address |
|---|---|---|
| DAWSON CHRISTINA DR. | Manager | 10244 East Colonial Drive, ORLANDO, FL, 32817 |
| DAWSON WALTER DR. | Manager | 10244 East Colonial Drive, ORLANDO, FL, 32817 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-03-11 | 10244 East Colonial Drive, Suite 204, ORLANDO, FL 32817 | No data |
| CHANGE OF MAILING ADDRESS | 2023-03-11 | 10244 East Colonial Drive, Suite 204, ORLANDO, FL 32817 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-03-11 | 10244 East Colonial Drive, Suite 204, ORLANDO, FL 32817 | No data |
| REGISTERED AGENT NAME CHANGED | 2022-04-24 | Dawson, Christina Marie, Dr. | No data |
| LC AMENDMENT | 2021-05-17 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-19 |
| ANNUAL REPORT | 2023-03-11 |
| ANNUAL REPORT | 2022-04-24 |
| LC Amendment | 2021-05-17 |
| Florida Limited Liability | 2021-03-17 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
