| Entity Name: | FAM HOSPITALIST LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 06 Dec 2021 (3 years ago) |
| Date of dissolution: | 23 Sep 2022 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (2 years ago) |
| Document Number: | L21000513886 |
| Address: | 13550 VILLAGE PARK DRIVE, UNIT 220, ORLANDO, FL 32837 |
| Mail Address: | 11310 LEMON LAKE BLVD, ORLANDO, FL 32836 |
| ZIP code: | 32837 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1669123287 | 2022-01-14 | 2022-01-14 | 11310 LEMON LAKE BLVD, ORLANDO, FL, 328365070, US | 13550 VILLAGE PARK DR STE 220, ORLANDO, FL, 328377835, US | |||||||||||||||||||||||||
|
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| Phone | +1 407-738-0803 |
Authorized person
| Name | ABBAS RIZVI |
| Role | OWNER |
| Phone | 4077380803 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 208M00000X - Hospitalist Physician |
| Is Primary | Yes |
| Taxonomy Code | 261QM2500X - Medical Specialty Clinic/Center |
| Is Primary | No |
Other Provider Identifiers
| Issuer | N/A |
| Number | 000000 |
| Name | Role | Address |
|---|---|---|
| RIZVI, ABBAS A | Agent | 11310 LEMON LAKE BLVD, ORLANDO, FL 32836 |
| Name | Role | Address |
|---|---|---|
| RIZVI, ABBAS A | Manager | 11310 LEMON LAKE BLVD, ORLANDO, FL 32836 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| Name | Date |
|---|---|
| Florida Limited Liability | 2021-12-06 |
Date of last update: 12 Feb 2025
Sources: Florida Department of State
