| Entity Name: | AVS MEDICAL LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 09 Nov 2021 (3 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 14 Nov 2022 (2 years ago) |
| Document Number: | L21000484640 |
| FEI/EIN Number | 87-3484911 |
| Address: | 4691 Old Canoe Creek Road, SAINT CLOUD, FL, 34769, US |
| Mail Address: | 4691 Old Canoe Creek Road, SAINT CLOUD, FL, 34769, US |
| ZIP code: | 34769 |
| County: | Osceola |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891418141 | 2022-09-21 | 2022-09-21 | 8149 GAMEMASTER AVE, ORLANDO, FL, 328325074, US | 4691 OLD CANOE CREEK RD, SAINT CLOUD, FL, 347691550, US | |||||||||||||
|
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| Phone | +1 407-498-4015 |
Authorized person
| Name | DR. AGUSTIN VEGA SANTIAGO |
| Role | PHYSICIAN/ OWNER |
| Phone | 7879690534 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| VEGA SANTIAGO AGUSTIN | Agent | 4691 Old Canoe Creek Road, SAINT CLOUD, FL, 34769 |
| Name | Role | Address |
|---|---|---|
| VEGA SANTIAGO AGUSTIN | Manager | 8149 GAMEMASTER AVE, ORLANDO, FL, 32832 |
| Name | Role | Address |
|---|---|---|
| ASTRID ROSA VELEZ | Authorized Member | 8149 GAMEMASTER AVE, ORLANDO, FL, 32832 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-20 | 4691 Old Canoe Creek Road, SAINT CLOUD, FL 34769 | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-20 | 4691 Old Canoe Creek Road, SAINT CLOUD, FL 34769 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-04-20 | VEGA SANTIAGO, AGUSTIN | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-20 | 4691 Old Canoe Creek Road, SAINT CLOUD, FL 34769 | No data |
| LC AMENDMENT | 2022-11-14 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-26 |
| ANNUAL REPORT | 2023-04-20 |
| LC Amendment | 2022-11-14 |
| ANNUAL REPORT | 2022-05-11 |
| Florida Limited Liability | 2021-11-09 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
