| Entity Name: | ISLAND HEALTH CONCIERGE MEDICINE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 11 Feb 2022 (3 years ago) |
| Document Number: | P22000012846 |
| FEI/EIN Number | 88-0877277 |
| Address: | 9301 Highway A1A,, SUITE 202, VERO BEACH., FL 32963 |
| Mail Address: | 9301 Highway A1A,, SUITE 202, VERO BEACH., FL 32963 |
| ZIP code: | 32963 |
| County: | Indian River |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1689353609 | 2023-07-17 | 2023-07-17 | PO BOX 643608, VERO BEACH, FL, 329643608, US | 9301 HIGHWAY A1A STE 202, VERO BEACH, FL, 329635602, US | |||||||||||||||||||||
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| Phone | +1 518-763-6969 |
| Fax | 7724105477 |
| Phone | +1 772-205-6361 |
Authorized person
| Name | LATIA H ILYADIS |
| Role | OWNER |
| Phone | 5187636969 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 208000000X - Pediatrics Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| ILYADIS, LATIA H | Agent | 9301 Highway A1A,, SUITE 202, VERO BEACH., FL 32963 |
| Name | Role | Address |
|---|---|---|
| ILYADIS, LATIA H | President | 6365 NEVIS CT., VERO BEACH, FL 32967 |
| Name | Role | Address |
|---|---|---|
| Ilyadis, George | Treasurer | 9301 Highway A1A,, SUITE 202 VERO BEACH., FL 32963 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-10-11 | 9301 Highway A1A,, SUITE 202, VERO BEACH., FL 32963 | No data |
| CHANGE OF MAILING ADDRESS | 2022-10-11 | 9301 Highway A1A,, SUITE 202, VERO BEACH., FL 32963 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-15 |
| AMENDED ANNUAL REPORT | 2023-04-17 |
| ANNUAL REPORT | 2023-02-14 |
| Domestic Profit | 2022-02-11 |
Date of last update: 12 Feb 2025
Sources: Florida Department of State
