| Entity Name: | INTREPID FAMILY MEDICINE PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 19 Oct 2021 (3 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year 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 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1831803121 | 2023-01-11 | 2023-01-11 | 1411 N FLAGLER DR STE 8200, WEST PALM BEACH, FL, 334013413, US | 1411 N FLAGLER DR STE 8200, WEST PALM BEACH, FL, 334013413, US | |||||||||||||||
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| Phone | +1 561-612-3200 |
| Fax | 5613355424 |
Authorized person
| Name | DR. DONALD LEVEILLE |
| Role | CEO |
| Phone | 5616123200 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
| Name | Role |
|---|---|
| SPIEGEL & UTRERA, P.A. | Agent |
| 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 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-04-23 | 1411 North Flagler Drive, Suite 8200, WEST PALM BEACH, FL 33401 | No data |
| CHANGE OF MAILING ADDRESS | 2022-04-23 | 1411 North Flagler Drive, Suite 8200, WEST PALM BEACH, FL 33401 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2022-04-23 |
| Florida Limited Liability | 2021-10-19 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
