| Entity Name: | SALAH AL-ANDARY, M.D., L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 19 Sep 2001 (23 years ago) |
| Date of dissolution: | 22 Sep 2017 (7 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2017 (7 years ago) |
| Document Number: | L01000016139 |
| FEI/EIN Number | 593746211 |
| Address: | 1920 WEST BAY DRIVE SUITE 6, ADDRESS<>ADDRESS2, LARGO, FL, 33770, US |
| Mail Address: | 1920 WEST BAY DRIVE SUITE 6, ADDRESS<>ADDRESS2, LARGO, FL, 33770, US |
| ZIP code: | 33770 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114090479 | 2006-11-16 | 2010-03-04 | 1920 WEST BAY DRIVE, SUITE #6, LARGO, FL, 33770, US | 1920 WEST BAY DRIVE, SUITE #6, LARGO, FL, 33770, US | |||||||||||||||||||||||||
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| Phone | +1 727-584-1344 |
| Fax | 7275847855 |
Authorized person
| Name | MS. SALAH F AL ANDARY |
| Role | OWNER |
| Phone | 7275841344 |
Taxonomy
| Taxonomy Code | 207RP1001X - Pulmonary Disease Physician |
| License Number | FLME0073452 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 252165200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ARSENAULT KENNETH G | Agent | 10225 ULMERTON ROAD, LARGO, FL, 33771 |
| Name | Role | Address |
|---|---|---|
| AL-ANDARY SALAH F | Manager | 2316 MESSENGER CIRCLE, SAFETY HARBOR, FL, 34695 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-02-13 | 1920 WEST BAY DRIVE SUITE 6, ADDRESS<>ADDRESS2, LARGO, FL 33770 | No data |
| CHANGE OF MAILING ADDRESS | 2011-02-13 | 1920 WEST BAY DRIVE SUITE 6, ADDRESS<>ADDRESS2, LARGO, FL 33770 | No data |
| REINSTATEMENT | 2003-10-27 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2003-09-26 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2016-01-30 |
| ANNUAL REPORT | 2015-03-22 |
| ANNUAL REPORT | 2014-02-09 |
| ANNUAL REPORT | 2013-03-02 |
| ANNUAL REPORT | 2012-01-19 |
| ANNUAL REPORT | 2011-02-13 |
| ANNUAL REPORT | 2010-01-16 |
| ANNUAL REPORT | 2009-01-24 |
| ANNUAL REPORT | 2008-01-22 |
| ANNUAL REPORT | 2007-07-03 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
