| Entity Name: | THE WAY MEDICAL GROUP LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
THE WAY MEDICAL GROUP 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: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 30 Aug 2022 (3 years ago) |
| Date of dissolution: | 02 Oct 2023 (2 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 02 Oct 2023 (2 years ago) |
| Document Number: | L22000381759 |
| FEI/EIN Number |
88-3756227
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 1030 VENETIAN DR, UNITE 202, MELBOURNE, FL, 32904, US |
| Mail Address: | 1030 VENETIAN WAY, UNITE 202, MELBOURNE, FL, 32904, US |
| ZIP code: | 32904 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1386365476 | 2022-09-07 | 2023-07-26 | 4780 DAIRY RD, MELBOURNE, FL, 329048482, US | 4780 DAIRY RD, MELBOURNE, FL, 329048482, US | |||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 321-989-2187 |
Authorized person
| Name | DR. JAY BOULDIN |
| Role | CEO |
| Phone | 3219892187 |
Taxonomy
| Taxonomy Code | 207QA0505X - Adult Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | No |
| Taxonomy Code | 246Z00000X - Other Specialist/Technologist |
| Is Primary | No |
| Taxonomy Code | 251J00000X - Nursing Care Agency |
| Is Primary | No |
| Taxonomy Code | 261QR0405X - Substance Use Disorder Rehabilitation Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QR1100X - Research Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 363LA2200X - Adult Health Nurse Practitioner |
| Is Primary | No |
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | No |
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | No |
| Taxonomy Code | 363LP2300X - Primary Care Nurse Practitioner |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| BOULDIN JAY | Chief Executive Officer | 1030 VENETIAN DR, UNIT 202, MELBOURNE, FL, 32904 |
| Bouldin Jay | Agent | 1030 VENETIAN WAY, MELBOURNE, FL, 32904 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2023-10-02 | - | - |
| REGISTERED AGENT NAME CHANGED | 2023-05-30 | Bouldin, Jay | - |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2023-10-02 |
| AMENDED ANNUAL REPORT | 2023-05-30 |
| ANNUAL REPORT | 2023-01-17 |
| Florida Limited Liability | 2022-08-30 |
Date of last update: 03 Apr 2025
Sources: Florida Department of State
