| Entity Name: | JELLINGER & LERMAN MD LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 28 Dec 2021 (3 years ago) |
| Last Event: | CONVERSION |
| Event Date Filed: | 28 Dec 2021 (3 years ago) |
| Document Number: | L21000533663 |
| FEI/EIN Number | 59-1681317 |
| Address: | 3107 STIRLING ROAD STE 300, FORT LAUDERDALE, FL 33312 |
| Mail Address: | 3107 STIRLING ROAD STE 300, FORT LAUDERDALE, FL 33312 |
| ZIP code: | 33312 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1013946862 | 2006-07-02 | 2022-10-11 | 3107 STIRLING ROAD, SUITE 300, FORT LAUDERDALE, FL, 33312, US | 3107 STIRLING ROAD, SUITE 300, FORT LAUDERDALE, FL, 33312, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 954-963-7100 |
| Fax | 9543372361 |
Authorized person
| Name | DR. PAUL STEPHEN JELLINGER |
| Role | PRESIDENT |
| Phone | 9549637100 |
Taxonomy
| Taxonomy Code | 207RE0101X - Endocrinology, Diabetes & Metabolism Physician |
| License Number | ME0022389 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 207RE0101X - Endocrinology, Diabetes & Metabolism Physician |
| License Number | ME0021354 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207RE0101X - Endocrinology, Diabetes & Metabolism Physician |
| License Number | ME0022427 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207RE0101X - Endocrinology, Diabetes & Metabolism Physician |
| License Number | ME86320 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | SAM LERMAN BC |
| Number | 14944 |
| Issuer | MEDICARE PTAN |
| Number | 14944B |
| State | FL |
| Issuer | PAUL JELLINGER BC |
| Number | 93115 |
| Issuer | MEDICARE PTAN |
| Number | K9029 |
| State | FL |
| Issuer | MEDICARE PTAN |
| Number | U0056W |
| State | FL |
| Issuer | MEDICARE PTAN |
| Number | 93115B |
| State | FL |
| Issuer | MEDICARE PTAN |
| Number | HR294Z |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MATZNER, GARY | Agent | 2800 PONCE DE LEON #1100, CORAL GABLES, FL 33134 |
| Name | Role | Address |
|---|---|---|
| JELLINGER, PAUL | Manager | 8647 LEWIS RIVER ROAD, DELRAY BEACH, FL 33446 |
| LERMAN, SAM | Manager | 1635 LAKESHORE CIRCLE, FORT LAUDERDALE, FL 33326 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000022420 | ENDOCRINOLOGY MEDICAL GROUP PRACTICE | ACTIVE | 2023-02-16 | 2028-12-31 | No data | 3107 STIRLING ROAD STE 300, FORT LAUDERDALE, FL, 33312 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CONVERSION | 2021-12-28 | No data | CORPORATION WAS A CONVERSION RESULT. CONVERTING CORPORATION WAS 509813. CONVERSION NUMBER 100000221831 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-07 |
| ANNUAL REPORT | 2023-02-06 |
| Florida Limited Liability | 2021-12-28 |
Date of last update: 12 Feb 2025
Sources: Florida Department of State
