| Entity Name: | NSB FAMILY MEDICINE TELEHEALTH, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 17 Apr 2023 (2 years ago) |
| Date of dissolution: | 27 Sep 2024 (4 months ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2024 (4 months ago) |
| Document Number: | L23000187799 |
| Address: | 735 WILLIAMS RD, NEW SMYRNA BEACH, FL, 32168, UN |
| Mail Address: | 735 WILLIAMS RD, NEW SMYRNA BEACH, FL, 32168, UN |
| ZIP code: | 32168 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1194416537 | 2023-05-17 | 2023-08-15 | 735 WILLIAMS RD, NEW SMYRNA BEACH, FL, 321687899, US | 735 WILLIAMS RD, NEW SMYRNA BEACH, FL, 321687899, US | |||||||||||||||
|
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| Phone | +1 386-837-1071 |
| Fax | 9496952561 |
Authorized person
| Name | MS. ROBINA WENDY BELANGER |
| Role | OWNER |
| Phone | 3868371071 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BALL GREGORY B | Agent | 735 WILLIAMS RD, NEW SMYRNA BEACH, FL, 32168 |
| Name | Role | Address |
|---|---|---|
| BELANGER ROBINA W | Manager | 735 WILLIAMS RD, NEW SMYRNA BEACH, FL, 32168 |
| BALL GREGORY B | Manager | 735 WILLIAMS RD, NEW SMYRNA BEACH, FL, 32168 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| Name | Date |
|---|---|
| Florida Limited Liability | 2023-04-17 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
