| Entity Name: | ACTIVE LIVING MEDICAL CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 04 Jun 2021 (4 years ago) |
| Document Number: | L21000261460 |
| FEI/EIN Number | 87-1288587 |
| Address: | 8257 NARCOOSSEE PARK DRIVE, SUITE 516, ORLANDO, FL, 32822, US |
| Mail Address: | 8257 NARCOOSSEE PARK DRIVE, SUITE 516, ORLANDO, FL, 32822, US |
| ZIP code: | 32822 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1346819448 | 2021-06-22 | 2021-06-24 | 8257 NARCOOSSEE PARK DR STE 516, ORLANDO, FL, 328225545, US | 8257 NARCOOSSEE PARK DR STE 516, ORLANDO, FL, 328225545, US | |||||||||||||||
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| Phone | +1 407-616-6279 |
| Phone | +1 407-384-4904 |
Authorized person
| Name | MS. JODI L JAKIEL |
| Role | OWNER |
| Phone | 4073844904 |
Taxonomy
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| JAKIEL Jodi L | Agent | 8257 NARCOOSSEE PARK DRIVE, ORLANDO, FL, 32822 |
| Name | Role | Address |
|---|---|---|
| Jakiel JODI | Chief Executive Officer | 8257 NARCOOSSEE PARK DRIVE, ORLANDO, FL, 32822 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-02-05 | 8257 NARCOOSSEE PARK DRIVE, SUITE 516, ORLANDO, FL 32822 | No data |
| CHANGE OF MAILING ADDRESS | 2022-02-05 | 8257 NARCOOSSEE PARK DRIVE, SUITE 516, ORLANDO, FL 32822 | No data |
| REGISTERED AGENT NAME CHANGED | 2022-02-05 | JAKIEL, Jodi L | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-02-05 | 8257 NARCOOSSEE PARK DRIVE, SUITE 516, ORLANDO, FL 32822 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-20 |
| ANNUAL REPORT | 2023-04-04 |
| AMENDED ANNUAL REPORT | 2022-02-27 |
| ANNUAL REPORT | 2022-02-05 |
| Florida Limited Liability | 2021-06-04 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
