| Entity Name: | TEQUESTA URGENT CARE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 04 Jun 2002 (23 years ago) |
| Document Number: | L02000014125 |
| FEI/EIN Number | 270023913 |
| Address: | 15757 Pines Blvd, Pembroke Pines, FL, 33027, US |
| Mail Address: | 12 ELAINE COURT, WOODCLIFF LAKE, NJ, 07677 |
| ZIP code: | 33027 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508840208 | 2005-12-06 | 2020-08-22 | 1 MAIN ST, SUITE 102, TEQUESTA, FL, 334694709, US | 1 MAIN ST, SUITE 102, TEQUESTA, FL, 334694709, US | |||||||||||||||||||||||||
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| Phone | +1 561-747-4464 |
| Fax | 5617475598 |
Authorized person
| Name | FRANCINE GRECO |
| Role | PARTNER |
| Phone | 5617474464 |
Taxonomy
| Taxonomy Code | 261QU0200X - Urgent Care Clinic/Center |
| License Number | HCC5420 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | B903F |
| State | FL |
| Name | Role | Address |
|---|---|---|
| RODRIGUEZ ROBERT | Agent | 2720 10th Ave North, Palm Springs, FL, 33461 |
| Name | Role | Address |
|---|---|---|
| RODRIGUEZ ROBERT | Manager | 15757 Pines Blvd, Pembroke Pines, FL, 33027 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2017-01-09 | No data | No data |
| LC AMENDED AND RESTATED ARTICLES | 2012-12-31 | No data | No data |
| LC AMENDMENT | 2010-12-27 | No data | No data |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
