| Entity Name: | FUNCTIONAL MEDICINE APRN LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 18 Jan 2022 (3 years ago) |
| Document Number: | L22000034344 |
| FEI/EIN Number | 87-4809555 |
| Address: | 3700 GOLDEN GATE BLVD W, NAPLES, FL, 34120 |
| Mail Address: | 3700 GOLDEN GATE BLVD W, NAPLES, FL, 34120 |
| ZIP code: | 34120 |
| County: | Collier |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1588311914 | 2022-03-05 | 2022-03-14 | 3700 GOLDEN GATE BLVD W, NAPLES, FL, 341203043, US | 7385 RADIO RD STE 104, NAPLES, FL, 341046705, US | |||||||||||||
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| Phone | +1 239-601-4659 |
Authorized person
| Name | KATHY VERDES |
| Role | OWNER |
| Phone | 2396014659 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| VERDES CONSTANTIN | Agent | 3700 GOLDEN GATE BLVD W, NAPLES, FL, 34120 |
| Name | Role | Address |
|---|---|---|
| VERDES KATHY | President | 3700 GOLDEN GATE BLVD W, NAPLES, FL, 34120 |
| Name | Role | Address |
|---|---|---|
| Verdes Constantin | Vice President | 3700 GOLDEN GATE BLVD W, NAPLES, FL, 34120 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000039527 | NAPLES CLINIC | ACTIVE | 2022-03-28 | 2027-12-31 | No data | 7385 RADIO RD, 104, NAPLES, FL, 34104 |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J24000586592 | TERMINATED | 1000001009522 | COLLIER | 2024-09-05 | 2034-09-11 | $ 352.38 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, FORT MYERS SERVICE CENTER, 2295 VICTORIA AVE STE 270, FORT MYERS FL339013871 |
| J24000586584 | TERMINATED | 1000001009519 | COLLIER | 2024-09-05 | 2044-09-11 | $ 4,984.47 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, FORT MYERS SERVICE CENTER, 2295 VICTORIA AVE STE 270, FORT MYERS FL339013871 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-06 |
| ANNUAL REPORT | 2023-01-03 |
| Florida Limited Liability | 2022-01-18 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
