| Entity Name: | SARNO PHARMACY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 04 Nov 2005 (19 years ago) |
| Last Event: | CANCEL ADM DISS/REV |
| Event Date Filed: | 11 Jan 2010 (15 years ago) |
| Document Number: | L05000107437 |
| FEI/EIN Number | 203746426 |
| Address: | 2176 SARNO ROAD, MELBOURNE, FL, 32935, US |
| Mail Address: | 2176 SARNO ROAD, MELBOURNE, FL, 32935, US |
| ZIP code: | 32935 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1306951330 | 2006-08-20 | 2023-03-07 | 2176 SARNO ROAD SUITE 120, MELBOURNE, FL, 32935, US | 2176 SARNO ROAD SUITE 120, MELBOURNE, FL, 32935, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 321-242-2440 |
| Fax | 3212422125 |
Authorized person
| Name | SUSAN NELSON |
| Role | OFFICE MANAGER |
| Phone | 3212422440 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| License Number | PH18118 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | OTHER ID NUMBER-COMMERCIAL NUMBER |
| Number | 1079917 |
| Issuer | MEDICAID |
| Number | 031123500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ACQUAVIVA CARL | Agent | 2176 SARNO ROAD, MELBOURNE, FL, 32935 |
| Name | Role | Address |
|---|---|---|
| ACQUAVIVA CARL | Managing Member | 1120 BAYWOOD CT, MALABAR, FL, 32950 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2014-01-08 | 2176 SARNO ROAD, 120, MELBOURNE, FL 32935 | No data |
| CHANGE OF MAILING ADDRESS | 2014-01-08 | 2176 SARNO ROAD, 120, MELBOURNE, FL 32935 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-01-08 | 2176 SARNO ROAD, 120, MELBOURNE, FL 32935 | No data |
| CANCEL ADM DISS/REV | 2010-01-11 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-02 |
| ANNUAL REPORT | 2024-01-03 |
| ANNUAL REPORT | 2023-01-20 |
| ANNUAL REPORT | 2022-01-05 |
| ANNUAL REPORT | 2021-01-21 |
| ANNUAL REPORT | 2020-01-29 |
| ANNUAL REPORT | 2019-05-06 |
| ANNUAL REPORT | 2018-01-13 |
| ANNUAL REPORT | 2017-02-21 |
| ANNUAL REPORT | 2016-01-27 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
