| Entity Name: | SARA J. BERNSTEIN, MD, LC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 22 Feb 2006 (19 years ago) |
| Date of dissolution: | 23 Sep 2011 (13 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2011 (13 years ago) |
| Document Number: | L06000019122 |
| FEI/EIN Number | 204348982 |
| Address: | 10131 W FOREST HILL BLVD, 130, WELLINGTON, FL, 33414, US |
| Mail Address: | 11924 W FOREST HILL BLVD, 22-313, WELLINGTON, FL, 33414, US |
| ZIP code: | 33414 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1851366934 | 2006-02-21 | 2009-07-15 | 11924 W FOREST HILL BLVD, SUITE 22-313, WELLINGTON, FL, 334146256, US | 10131 W FOREST HILL BLVD, SUITE 130, WELLINGTON, FL, 334146156, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 561-784-1933 |
| Fax | 5617845109 |
Authorized person
| Name | DR. SARA J BERNSTEIN |
| Role | MANAGING MEMBER |
| Phone | 5617841933 |
Taxonomy
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| License Number | ME 79627 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | DIMENSION HEALTH |
| Number | 20-1124411 |
| State | FL |
| Issuer | GREAT WEST |
| Number | 20-1124411 |
| State | FL |
| Issuer | PRIVATE HEALTHCARE SYSTEM |
| Number | 20-1124411 |
| State | FL |
| Issuer | MEDICAID |
| Number | 264231000 |
| State | FL |
| Issuer | AVMED |
| Number | 298473 |
| State | FL |
| Issuer | CIGNA |
| Number | 7531723 |
| State | FL |
| Issuer | BLUE CROSS / BLUE SHIELD |
| Number | 51338 |
| State | FL |
| Issuer | NEIGHBORHOOD HEALTH |
| Number | 45664 |
| State | FL |
| Issuer | UNITED |
| Number | 20-1124411 |
| State | FL |
| Issuer | AETNA |
| Number | 7872461 |
| State | FL |
| Issuer | BEECH STREET |
| Number | 20-1124411 |
| State | FL |
| Issuer | ONE-SOURCE |
| Number | 20-1124411 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BERNSTEIN GLEN C | Agent | 11924 W FOREST HILL BLVD, WELLINGTON, FL, 33414 |
| Name | Role | Address |
|---|---|---|
| BERNSTEIN SARA J | Managing Member | 11924 W FOREST HILL BLVD, #22-313, WELLINGTON, FL, 33414 |
| BERNSTEIN GLEN C | Managing Member | 11924 W FOREST HILL BLVD, #22-313, WELLINGTON, FL, 33414 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-05-01 | 10131 W FOREST HILL BLVD, 130, WELLINGTON, FL 33414 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2010-05-13 |
| ANNUAL REPORT | 2009-05-01 |
| ANNUAL REPORT | 2008-04-02 |
| ANNUAL REPORT | 2007-01-30 |
| Florida Limited Liability | 2006-02-22 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
