| Entity Name: | SHORES MEDICAL CENTER LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 12 Dec 2003 (21 years ago) |
| Date of dissolution: | 16 Sep 2005 (19 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 16 Sep 2005 (19 years ago) |
| Document Number: | L03000054627 |
| FEI/EIN Number | 562423941 |
| Address: | 9345 PARK DRIVE, MIAMI SHORES, FL, 33138 |
| Mail Address: | P.O. BOX 21173, FT LAUDERDALE, FL, 33335-1173 |
| ZIP code: | 33138 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1215334370 | 2014-12-04 | 2014-12-04 | 3512 S ATLANTIC AVE, DAYTONA BEACH SHORES, FL, 321187639, US | 3512 S ATLANTIC BLVD, DAYTONA BEACH SHORES, FL, 32118, US | |||||||||||||||||
|
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| Phone | +1 386-767-9544 |
Authorized person
| Name | DR. GERALD WOODARD |
| Role | OWNER |
| Phone | 3867679544 |
Taxonomy
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| License Number | ARNP 3088302 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| EUDOVIQUE SAMUEL J | Agent | 1301 NW 175 TERR, MIAMI, FL, 33169 |
| Name | Role | Address |
|---|---|---|
| EUDOVIQUE SAMUEL J | Manager | 1301 NW 175 TERR, MIAMI, FL, 33169 |
| KIRKLAND LESLIE B | Manager | 16903 SW 34TH STREET, MIRAMAR, FL, 33027 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2005-09-16 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2004-09-09 |
| Florida Limited Liabilites | 2003-12-12 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
