| Entity Name: | DOCTA LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 16 Mar 2006 (19 years ago) |
| Document Number: | L06000028042 |
| FEI/EIN Number | 020771219 |
| Address: | 5200 S. University Drive, Davie, FL, 33328, US |
| Mail Address: | 5200 S. University Drive, Davie, FL, 33328, US |
| ZIP code: | 33328 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1558836445 | 2018-10-08 | 2018-10-08 | 5200 S UNIVERSITY DR STE 102A, DAVIE, FL, 333285316, US | 5200 S UNIVERSITY DR STE 102A, DAVIE, FL, 333285316, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 754-444-8503 |
| Fax | 5619074984 |
Authorized person
| Name | JESSICA HEGEDUS |
| Role | OFFICE MANAGER/BILLING SPECIALIST |
| Phone | 7544448503 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| Is Primary | Yes |
| Taxonomy Code | 207ND0900X - Dermatopathology Physician |
| Is Primary | No |
| Taxonomy Code | 207NI0002X - Clinical & Laboratory Dermatological Immunology Physician |
| Is Primary | No |
Other Provider Identifiers
| Issuer | FLORIDA DEPARTMENT OF HEALTH |
| Number | ME88101 |
| State | FL |
| Issuer | NPPES |
| Number | 1477538940 |
| Name | Role | Address |
|---|---|---|
| SNYDER SHAWN C | Agent | 7931 S.W. 45TH STREET, DAVIE, FL, 33328 |
| Name | Role | Address |
|---|---|---|
| NOUSARI CARLOS H | Manager | 5200 S. University Drive, Davie, FL, 33328 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2014-03-03 | 5200 S. University Drive, Unit 102, Davie, FL 33328 | No data |
| CHANGE OF MAILING ADDRESS | 2014-03-03 | 5200 S. University Drive, Unit 102, Davie, FL 33328 | No data |
| REGISTERED AGENT NAME CHANGED | 2012-04-10 | SNYDER, SHAWN C | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-04-10 | 7931 S.W. 45TH STREET, DAVIE, FL 33328 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-11 |
| ANNUAL REPORT | 2023-04-25 |
| ANNUAL REPORT | 2022-03-24 |
| ANNUAL REPORT | 2021-04-23 |
| ANNUAL REPORT | 2020-03-06 |
| ANNUAL REPORT | 2019-04-29 |
| ANNUAL REPORT | 2018-04-29 |
| ANNUAL REPORT | 2017-03-21 |
| ANNUAL REPORT | 2016-02-19 |
| ANNUAL REPORT | 2015-03-09 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
