| Entity Name: | EXCEPTIONAL URGENT CARE CENTER I, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
EXCEPTIONAL URGENT CARE CENTER I, INC. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 16 Feb 2004 (21 years ago) |
| Document Number: | P04000032958 |
| FEI/EIN Number |
200760917
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 13767 US HWY 441, Lady Lake, FL, 32159, US |
| Mail Address: | 13767 US HWY 441, Lady Lake, FL, 32159, US |
| ZIP code: | 32159 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1700898467 | 2006-08-12 | 2009-01-15 | 11950 COUNTY ROAD 101, SUITE #101, THE VILLAGES, FL, 321629332, US | 11950 COUNTY ROAD 101, SUITE #101, THE VILLAGES, FL, 321629332, US | |||||||||||||||||||||||||
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| Phone | +1 352-391-5200 |
| Fax | 3523915903 |
Authorized person
| Name | DR. JOHN JOSEPH IM |
| Role | DIRECTOR |
| Phone | 3523915200 |
Taxonomy
| Taxonomy Code | 261QU0200X - Urgent Care Clinic/Center |
| License Number | OS8729 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 265844500 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| EXCEPTIONAL URGENT CARE 401(K) PLAN | 2023 | 200760917 | 2024-05-02 | EXCEPTIONAL URGENT CARE CENTER I | 3 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 474474775 |
| Plan administrator’s name | GUIDELINE, INC. |
| Plan administrator’s address | 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number | 8882283491 |
Signature of
| Role | Plan administrator |
| Date | 2024-05-02 |
| Name of individual signing | QIAN LIU |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-01-01 |
| Business code | 621493 |
| Sponsor’s telephone number | 3523915200 |
| Plan sponsor’s address | 13767 N US HIGHWAY 441, LADY LAKE, FL, 32159 |
Plan administrator’s name and address
| Administrator’s EIN | 474474775 |
| Plan administrator’s name | GUIDELINE, INC. |
| Plan administrator’s address | 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number | 8882283491 |
Signature of
| Role | Plan administrator |
| Date | 2023-05-30 |
| Name of individual signing | CHRISTINE RIMER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| IM JOHN J | Director | 13767 US HWY 441, Lady Lake, FL, 32159 |
| IM JOHN J | Agent | 7722 SE 12th CIRCLE, OCALA, FL, 34480 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2021-03-14 | IM, JOHN J. | - |
| REGISTERED AGENT ADDRESS CHANGED | 2021-03-14 | 7722 SE 12th CIRCLE, OCALA, FL 34480 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2019-08-01 | 13767 US HWY 441, Lady Lake, FL 32159 | - |
| CHANGE OF MAILING ADDRESS | 2019-08-01 | 13767 US HWY 441, Lady Lake, FL 32159 | - |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J16000256119 | LAPSED | 2013-CA-1105 | CIRCUIT COURT - SUMTER COUNTY | 2016-03-22 | 2021-04-18 | $176,396.81 | PINEDA REO, LLC, 99 HIGH STREET, 7TH FLOOR, ATTN: JULIE MCINTOSH, BOSTON, MA 2110 |
| J11000651997 | LAPSED | 11-CA-702 | 5TH JUDICIAL CIRCUIT | 2011-10-03 | 2016-10-06 | $213,123.35 | WELLS FARGO EQUIPMENT FINANCE, INC., 733 MARQUETTE AVENUE, SUITE 700, MINNEAPOLIS, MN 55402 |
| J11000501093 | LAPSED | 2010 CA 000327 | SUMTER COUNTY | 2011-05-25 | 2016-08-08 | $69,689.93 | HITACHI CAPITAL AMERICA CORP., 800 CONNECTICUT AVENUE, NORWALK, CT 06854 |
| J11000002456 | LAPSED | 42-2010-CA-001801 | CIRCUIT COURT MARION COUNTY | 2010-12-20 | 2016-01-04 | $62,798.60 | REGIONS BANK, 1900 FIFTH AVENUE NORTH, BIRMINGHAM AL 35203 |
| J11000002381 | LAPSED | 42-2010-CA-001801 | CIRCUIT COURT MARION COUNTY | 2010-12-20 | 2016-01-04 | $65,000 | REGIONS BANK, 1900 FIFTH AVENUE NORTH, TAMPA, FL 33602 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-11 |
| ANNUAL REPORT | 2023-05-01 |
| ANNUAL REPORT | 2022-03-25 |
| ANNUAL REPORT | 2021-03-14 |
| ANNUAL REPORT | 2020-06-10 |
| AMENDED ANNUAL REPORT | 2019-08-01 |
| ANNUAL REPORT | 2019-02-25 |
| ANNUAL REPORT | 2018-04-07 |
| ANNUAL REPORT | 2017-03-15 |
| ANNUAL REPORT | 2016-01-15 |
Date of last update: 03 May 2025
Sources: Florida Department of State
