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GOLDEN AGE PHYSICIAN SPECIALISTS, LLC - Florida Company Profile

Company Details

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.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act

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

National Provider Identifier

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

Contacts

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

Key Officers & Management

Name Role Address
DSTM MANAGEMENT, L.L.C. Manager -
Monticello Kimberly I Agent 5401 West Kennedy Boulevard, TAMPA, FL, 33609

Fictitious Names

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

Events

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 -

Documents

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