| Entity Name: | SEBASTIAN INTERNAL MEDICINE ASSOCIATES, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 07 Jul 2022 (3 years ago) |
| Document Number: | L22000304214 |
| FEI/EIN Number | 92-1514966 |
| Address: | 1627 US HIGHWAY 1, SUITE 201, SEBASTIAN, FL 32958 |
| Mail Address: | 1627 US HIGHWAY 1, SUITE 201, SEBASTIAN, FL 32958 |
| ZIP code: | 32958 |
| County: | Indian River |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1629782776 | 2023-01-12 | 2023-04-21 | 1627 US HIGHWAY 1, SEBASTIAN, FL, 329583899, US | 1627 US HIGHWAY 1, SEBASTIAN, FL, 329583899, US | |||||||||||||||
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| Phone | +1 772-388-2110 |
| Fax | 7723882426 |
Authorized person
| Name | MRS. MICHELLE BEAL |
| Role | BILLING MANAGER |
| Phone | 7723882110 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Venazio, Michael A | Agent | 1627 US Hwy 1, Suite 201, Sebastian, FL 32958 |
| Name | Role | Address |
|---|---|---|
| VENAZIO, MICHAEL A | Manager | 1627 US Hwy 1, Suite 201 SEBASTIAN, FL 32958 |
| Name | Role | Address |
|---|---|---|
| Gerard, Jennifer | Mgr | 1627 US HIGHWAY 1, SUITE 201 SEBASTIAN, FL 32958 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2023-03-09 | Venazio, Michael A | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-03-09 | 1627 US Hwy 1, Suite 201, Sebastian, FL 32958 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-08-23 | 1627 US HIGHWAY 1, SUITE 201, SEBASTIAN, FL 32958 | No data |
| CHANGE OF MAILING ADDRESS | 2022-08-23 | 1627 US HIGHWAY 1, SUITE 201, SEBASTIAN, FL 32958 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-15 |
| ANNUAL REPORT | 2023-03-09 |
| Florida Limited Liability | 2022-07-07 |
Date of last update: 11 Feb 2025
Sources: Florida Department of State
