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INTREPID FAMILY MEDICINE PLLC - Florida Company Profile

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Company Details

Entity Name: INTREPID FAMILY MEDICINE PLLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 19 Oct 2021 (4 years ago)
Date of dissolution: 22 Sep 2023 (2 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 22 Sep 2023 (2 years ago)
Document Number: L21000455606
FEI/EIN Number 87-3184828
Address: 1411 North Flagler Drive, WEST PALM BEACH, FL, 33401, US
Mail Address: 1411 North Flagler Drive, WEST PALM BEACH, FL, 33401, US
ZIP code: 33401
City: West Palm Beach
County: Palm Beach
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
LEVEILLE DONALD Manager 6313 C DURHAM DR, LAKE WORTH, FL, 33467
EMILE STACY D Manager 6313 C DURHAM DR, LAKE WORTH, FL, 33467
SPIEGEL & UTRERA, P.A. Agent 1840 SW 22ND ST., MIAMI, FL, 33145

National Provider Identifier

NPI Number:
1831803121
Certification Date:
2023-01-11

Authorized Person:

Name:
DR. DONALD LEVEILLE
Role:
CEO
Phone:

Taxonomy:

Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
5613355424

Events

Event Type Filed Date Value Description
REINSTATEMENT 2025-03-04 - -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2023-09-22 - -
CHANGE OF PRINCIPAL ADDRESS 2022-04-23 1411 North Flagler Drive, Suite 8200, WEST PALM BEACH, FL 33401 -
CHANGE OF MAILING ADDRESS 2022-04-23 1411 North Flagler Drive, Suite 8200, WEST PALM BEACH, FL 33401 -

Documents

Name Date
ANNUAL REPORT 2022-04-23
Florida Limited Liability 2021-10-19

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Date of last update: 02 Aug 2025

Sources: Florida Department of State