| Entity Name: | MODERN PHARMACY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 01 Feb 2002 (23 years ago) |
| Document Number: | L02000002572 |
| FEI/EIN Number | 900007861 |
| Address: | 123 ALTON ROAD, MIAMI BEACH, FL, 33139, US |
| Mail Address: | 123 ALTON ROAD, MIAMI BEACH, FL, 33139, US |
| ZIP code: | 33139 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1558430629 | 2006-11-06 | 2024-06-28 | 123 ALTON ROAD, MIAMI BEACH, FL, 331396708, US | 123 ALTON ROAD, MIAMI BEACH, FL, 331396708, US | |||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 305-531-3784 |
| Fax | 3055313779 |
Authorized person
| Name | MR. MICHAEL ROSENBAUM |
| Role | ATTORNEY, COMPLIANCE OFFICER |
| Phone | 3055313784 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH18913 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 025530101 |
| State | FL |
| Issuer | NCPDP |
| Number | 1097410 |
| State | FL |
| Issuer | MEDICAID |
| Number | 025530100 |
| State | FL |
| Name | Role |
|---|---|
| ROSENBAUM INTERNATIONAL LAW FIRM, P.A. | Agent |
| Name | Role | Address |
|---|---|---|
| Rosenbaum, Michael PA | Manager | c/o Rosenbaum International Law Firm, P.A., Miami Beach, FL, 33140 |
| Name | Role | Address |
|---|---|---|
| ROSENBAUM BERTA | Auth | c/o Rosenbaum International Law Firm, P.A., MIAMI BEACH, FL, 33140 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000065444 | MIDTOWN PHARMACY | ACTIVE | 2018-06-05 | 2028-12-31 | No data | ROSENBAUM INTERNATIONAL LAW FIRM, P.A., 755 W 41ST STREET, MIAMI BEACH, FL, 33140 |
| G16000130190 | MIRACLE RELIEF | ACTIVE | 2016-12-04 | 2026-12-31 | No data | MIRACLE RELIEF, 755 WEST 41ST STREET, FLOOR # 2, MIAMI BEACH, FL, 33140 |
| G12000056705 | MIDTOWN PHARMACY | EXPIRED | 2012-06-11 | 2017-12-31 | No data | ROSENBAUM INTERNATIONAL LAW FIRM, P.A., 755 W 41ST STREET, MIAMI BEACH, FL, 33140 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2008-10-21 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J13000777095 | TERMINATED | 10-23836CA(02) | 11TH JUDICIAL CIRCUIT | 2013-04-12 | 2018-04-29 | $56,160.83 | OCEAN BANK, 780 NW 42 AVENUE, SUITE 300, MIAMI, FL 33126 |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
