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LIVE OAK FAMILY PRACTICE LLC - Florida Company Profile

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Company Details

Entity Name: LIVE OAK FAMILY PRACTICE LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 21 May 2021 (4 years ago)
Document Number: L21000237127
FEI/EIN Number 86-3984428
Address: 1304 OHIO AVENUE SOUTH, LIVE OAK, FL, 32064
Mail Address: 1609 SW 17TH STR, OCALA, FL, 34471, US
ZIP code: 32064
City: Live Oak
County: Suwannee
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
GREENBERG JEFFREY PA Agent 1609 SW 17TH STR, OCALA, FL, 34471
Qamar Asad President 1304 OHIO AVENUE SOUTH, LIVE OAK, FL, 32064

National Provider Identifier

NPI Number:
1134892201
Certification Date:
2021-07-26

Authorized Person:

Name:
MELISSA F PETERS
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
363LP2300X - Primary Care Nurse Practitioner
Is Primary:
Yes

Contacts:

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2025-02-05 Qamar, Asad -
REGISTERED AGENT ADDRESS CHANGED 2025-02-05 1304 OHIO AVENUE SOUTH, LIVE OAK, FL 32064 -

Documents

Name Date
ANNUAL REPORT 2025-02-05
ANNUAL REPORT 2024-04-29
ANNUAL REPORT 2023-04-26
ANNUAL REPORT 2022-04-29
Florida Limited Liability 2021-05-21

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Date of last update: 03 Aug 2025

Sources: Florida Department of State