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VILLAGES INTERNAL MEDICINE AND SENIOR CLINIC, PA - Florida Company Profile

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Company Details

Entity Name: VILLAGES INTERNAL MEDICINE AND SENIOR CLINIC, PA
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 14 Aug 2003 (22 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 21 Oct 2021 (4 years ago)
Document Number: P03000089100
FEI/EIN Number 760739954
Address: 3351 WEDGEWOOD LANE, THE VILLAGES, FL, 32162
Mail Address: 3351 WEDGEWOOD LANE, THE VILLAGES, FL, 32162
ZIP code: 32162
City: The Villages
County: Sumter
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
EVALLE WINSTON Agent 433 Sunnyside Drive, LEESBURG, FL, 34748
EVALLE WINSTON Manager 433 Sunnyside Drive, LEESBURG, FL, 34748
EVALLE WINSTON Director 433 Sunnyside Drive, LEESBURG, FL, 34748
Cipriano Josephine G Secretary 433 Sunnyside Drive, LEESBURG, FL, 34748

National Provider Identifier

NPI Number:
1801939277

Authorized Person:

Name:
DR. WINSTON EVALLE
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207RG0300X - Geriatric Medicine (Internal Medicine) Physician
Is Primary:
No
Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
3522592174

Form 5500 Series

Employer Identification Number (EIN):
760739954
Plan Year:
2023
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
2
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
2
Sponsors Telephone Number:

Events

Event Type Filed Date Value Description
REINSTATEMENT 2021-10-21 - -
REGISTERED AGENT NAME CHANGED 2021-10-21 EVALLE, WINSTON -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2021-09-24 - -
REGISTERED AGENT ADDRESS CHANGED 2016-03-02 433 Sunnyside Drive, LEESBURG, FL 34748 -
CHANGE OF MAILING ADDRESS 2009-02-02 3351 WEDGEWOOD LANE, THE VILLAGES, FL 32162 -

Documents

Name Date
ANNUAL REPORT 2024-01-18
ANNUAL REPORT 2023-01-12
ANNUAL REPORT 2022-02-26
REINSTATEMENT 2021-10-21
ANNUAL REPORT 2020-03-30
ANNUAL REPORT 2019-03-19
ANNUAL REPORT 2018-04-02
ANNUAL REPORT 2017-02-17
ANNUAL REPORT 2016-03-02
ANNUAL REPORT 2015-02-24

USAspending Awards / Financial Assistance

Date:
2020-04-08
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
24775.00
Total Face Value Of Loan:
24775.00

Paycheck Protection Program

Jobs Reported:
4
Initial Approval Amount:
$24,775
Date Approved:
2020-04-08
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$24,775
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Male Owned
Veteran:
Unanswered
Forgiveness Amount:
$25,026.14
Servicing Lender:
Citizens First Bank
Use of Proceeds:
Payroll: $18,581.25
Rent: $6,193.75

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Date of last update: 01 Aug 2025

Sources: Florida Department of State