| Entity Name: | INTERNAL MEDICINE & PRIMARY CARE OF SEBASTIAN, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 17 Nov 2023 (a year ago) |
| Document Number: | L23000521128 |
| FEI/EIN Number | 93-4598685 |
| Address: | 7955 Bay Street, Sebastian, FL 32958 |
| Mail Address: | 261 BRIARCLIFF CIR., SEBASTIAN, FL 32958 |
| ZIP code: | 32958 |
| County: | Indian River |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1134998396 | 2023-12-28 | 2024-03-07 | 14499 US HIGHWAY 1, SEBASTIAN, FL, 329583238, US | 7955 BAY ST, SEBASTIAN, FL, 329583282, US | |||||||||||||
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| Phone | +1 862-236-0956 |
Authorized person
| Name | SALMA KHAN |
| Role | MANAGER |
| Phone | 6098517860 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| PIERRE, EDECK | Agent | 261 BRIARCLIFF CIR., SEBASTIAN, FL 32958 |
| Name | Role | Address |
|---|---|---|
| PIERRE, EDECK | Authorized Member | 261 BRIARCLIFF CIR., SEBASTIAN, FL 32958 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-08-15 | 7955 Bay Street, Sebastian, FL 32958 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-08-15 |
| Florida Limited Liability | 2023-11-17 |
Date of last update: 08 Jan 2025
Sources: Florida Department of State
