| Entity Name: | ORLANDO FREEDOM MEDICAL CLINIC, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 25 Nov 2020 (4 years ago) |
| Document Number: | P20000093517 |
| FEI/EIN Number | 854191542 |
| Address: | 331 N. MAITLAND AVE, SUITE D-2, MAITLAND, FL, 32751, US |
| Mail Address: | 331 N. MAITLAND AVE, SUITE D-2, MAITLAND, FL, 32751, US |
| ZIP code: | 32751 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1023601259 | 2021-02-18 | 2021-02-18 | 331 N MAITLAND AVE STE D2, MAITLAND, FL, 327514755, US | 331 N MAITLAND AVE STE D2, MAITLAND, FL, 327514755, US | |||||||||||||||||||
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| Phone | +1 407-636-4100 |
| Fax | 4076364126 |
Authorized person
| Name | DR. ROBERT R REPPY |
| Role | OWNER/PROVIDER |
| Phone | 4076364100 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | OWCP DEPARTMENT OF LABOR |
| Number | 716944700 |
| Name | Role | Address |
|---|---|---|
| Reppy Robert R | Agent | 331 N. MAITLAND AVE, MAITLAND, FL, 32751 |
| Name | Role | Address |
|---|---|---|
| REPPY ROBERT R | President | 331 N. MAITLAND AVE, MAITLAND, FL, 32751 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2021-01-04 | Reppy, Robert R | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-02-22 |
| ANNUAL REPORT | 2022-03-18 |
| ANNUAL REPORT | 2021-01-04 |
| Domestic Profit | 2020-11-25 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
