| Entity Name: | GOLDEN AGE PHYSICIAN SPECIALISTS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
GOLDEN AGE PHYSICIAN SPECIALISTS, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 22 Jun 2022 (3 years ago) |
| Document Number: | L22000282491 |
| FEI/EIN Number |
882917136
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Mail Address: | P.O. BOX 2066, LECANTO, FL, 34460, US |
| Address: | 6405 West Gulf to Lake Highway, Crystal River, FL, 34429, US |
| ZIP code: | 34429 |
| County: | Citrus |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1104520717 | 2023-03-28 | 2023-05-18 | PO BOX 2066, LECANTO, FL, 344602066, US | 6405 W GULF TO LAKE HWY, CRYSTAL RIVER, FL, 344299354, US | |||||||||||||||||||||
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| Phone | +1 352-684-8736 |
Authorized person
| Name | DACELIN ST. MARTIN |
| Role | PROVIDER |
| Phone | 3526848736 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| DSTM MANAGEMENT, L.L.C. | Manager | - |
| Monticello Kimberly I | Agent | 5401 West Kennedy Boulevard, TAMPA, FL, 33609 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000098805 | MHST | ACTIVE | 2023-08-23 | 2028-12-31 | - | 1990 N PROSPECT AVE, LECANTO, FL, 34461 |
| G22000146827 | GAPS HEALTHCARE | ACTIVE | 2022-11-29 | 2027-12-31 | - | 6405 W GULF TO LAKE HWY, CRYSTAL RIVER, FL, 34429 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-04-30 | Monticello, Kimberly Isner | - |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-30 | 5401 West Kennedy Boulevard, Suite 100, TAMPA, FL 33609 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2022-09-30 | 6405 West Gulf to Lake Highway, Crystal River, FL 34429 | - |
| CHANGE OF MAILING ADDRESS | 2022-08-31 | 6405 West Gulf to Lake Highway, Crystal River, FL 34429 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-05-01 |
| Florida Limited Liability | 2022-06-22 |
Date of last update: 01 Mar 2025
Sources: Florida Department of State
