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PREMISE HEALTH OF FLORIDA MEDICAL, P.A.

Company Details

Entity Name: PREMISE HEALTH OF FLORIDA MEDICAL, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 21 Aug 2008 (16 years ago)
Last Event: AMENDMENT AND NAME CHANGE
Event Date Filed: 14 Feb 2022 (3 years ago)
Document Number: P08000077945
FEI/EIN Number 263235124
Address: 5500 Maryland Way, Brentwood, TN, 37027, US
Mail Address: 5500 Maryland Way, Brentwood, TN, 37027, US
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1750100889 2024-10-07 2024-10-07 5500 MARYLAND WAY STE 120, BRENTWOOD, TN, 370274993, US 4700 WEST SANDLAKE RD, ORLANDO, FL, 32819, US

Contacts

Phone +1 407-224-2273
Fax 4072646494

Authorized person

Name JONATHAN LEIZMAN
Role PRESIDENT
Phone 6154682790

Taxonomy

Taxonomy Code 261QM1300X - Multi-Specialty Clinic/Center
Is Primary Yes

Agent

Name Role
CORPORATION SERVICE COMPANY Agent

Secretary

Name Role Address
Wright William D Secretary 5500 Maryland Way, Brentwood, TN, 37027

Treasurer

Name Role Address
Farrington Shannon Treasurer 5500 Maryland Way, Brentwood, TN, 37027

President

Name Role Address
LEIZMAN, M.D. JONATHAN President 5500 Maryland Way, Brentwood, TN, 37027

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G24000096308 TEAM CARE NORTH HEALTH CENTER ACTIVE 2024-08-13 2029-12-31 No data 5500 MARYLAND WAY, STE. 120, ATTN COMPLIANCE, BRENTWOOD, TN, 37027
G24000065291 HGV WELLNESS CENTER ACTIVE 2024-05-21 2029-12-31 No data 5500 MARYLAND WAY, STE. 120, BRENTWOOD, TN, 37027
G24000012251 RTX COLLINS - MELBOURNE ACTIVE 2024-01-22 2029-12-31 No data 5500 MARYLAND WAY, STE. 120, BRENTWOOD, TN, 37027
G24000002054 PALM BEACH GARDENS HEALTH AND WELLNESS ACTIVE 2024-01-05 2029-12-31 No data ATTN: COMPLIANCE, 5500 MARYLAND WAY. STE 120, BRENTWOOD, TN, 37027
G23000022982 HEALTHY 4 LIFE EMPLOYEE HEALTH CENTER ACTIVE 2023-02-17 2028-12-31 No data 5500 MARYLAND WAY, STE. 120, ATTN: COMPLIANCE, BRENTWOOD, TN, 37027
G22000124983 LAKE CO SHERIFF EMPLOYEE HEALTH & WELLNESS CENTER CLERMONT ACTIVE 2022-10-05 2027-12-31 No data 5500 MARYLAND WAY, STE. 120, BRENTWOOD, TN, 37027
G22000054523 CENTER FOR LIVING WELL-CELEBRATION ACTIVE 2022-04-29 2027-12-31 No data 5500 MARYLAND WAY, STE. 120, BRENTWOOD, TN, 37027
G22000053295 PREMISE HEALTH CLINIC ACTIVE 2022-04-27 2027-12-31 No data 5500 MARYLAND WAY, STE. 120, BRENTWOOD, TN, 37027
G22000050075 PGT WELLNESS CENTER ACTIVE 2022-04-20 2027-12-31 No data 5500 MARYLAND WAY, STE. 120, BRENTWOOD, TN, 37027
G21000161328 THE DB HEALTH & WELLBEING CENTER ACTIVE 2021-12-06 2026-12-31 No data 5500 MARYLAND WAY, STE. 120, BRENTWOOD, TN, 37027

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-02-07 5500 Maryland Way, Suite 120, Brentwood, TN 37027 No data
CHANGE OF MAILING ADDRESS 2024-02-07 5500 Maryland Way, Suite 120, Brentwood, TN 37027 No data
AMENDMENT AND NAME CHANGE 2022-02-14 PREMISE HEALTH OF FLORIDA MEDICAL, P.A. No data
REGISTERED AGENT NAME CHANGED 2010-01-04 CORPORATION SERVICE COMPANY No data
REGISTERED AGENT ADDRESS CHANGED 2010-01-04 1201 HAYS STREET, TALLAHASSEE, FL 32301-2525 No data

Documents

Name Date
AMENDED ANNUAL REPORT 2024-02-07
ANNUAL REPORT 2024-02-06
ANNUAL REPORT 2023-04-06
ANNUAL REPORT 2022-04-24
Amendment and Name Change 2022-02-14
ANNUAL REPORT 2021-01-13
ANNUAL REPORT 2020-01-15
ANNUAL REPORT 2019-05-04
AMENDED ANNUAL REPORT 2018-09-26
ANNUAL REPORT 2018-04-24

Date of last update: 02 Feb 2025

Sources: Florida Department of State