| Entity Name: | SKELLY MEDICAL GROUP LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 05 Oct 2022 (2 years ago) |
| Document Number: | L22000430265 |
| FEI/EIN Number | 92-0642516 |
| Address: | 2045 Fountain Professional Ct, STE C, Navarre, FL 32566 |
| Mail Address: | 2045 Fountain Professional Ct, STE C, Navarre, FL 32566 |
| ZIP code: | 32566 |
| County: | Santa Rosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1255018834 | 2023-07-05 | 2023-07-24 | 7223 RIVERVIEW ST, NAVARRE, FL, 325666602, US | 2045 FOUNTAIN PROFESSIONAL CT STE C, NAVARRE, FL, 325665108, US | |||||||||||||||
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| Phone | +1 813-727-9881 |
| Phone | +1 850-407-1914 |
Authorized person
| Name | SARAH SKELLY |
| Role | OWNER/PHYSICIAN |
| Phone | 8137279881 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| REGISTERED AGENTS INC | Agent |
| Name | Role | Address |
|---|---|---|
| SKELLY, SARAH, DO | Manager | 7223 RIVERVIEW ST., NAVARRE, FL 32566 |
| BENTON, DERRICK | Manager | 7223 RIVERVIEW ST., NAVARRE, FL 32566 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-08-01 | 2045 Fountain Professional Ct, STE C, Navarre, FL 32566 | No data |
| CHANGE OF MAILING ADDRESS | 2023-08-01 | 2045 Fountain Professional Ct, STE C, Navarre, FL 32566 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-02-06 |
| ANNUAL REPORT | 2024-03-11 |
| ANNUAL REPORT | 2023-08-01 |
| Florida Limited Liability | 2022-10-05 |
Date of last update: 11 Feb 2025
Sources: Florida Department of State
