| Entity Name: | LIBRA HEALTHCARE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 01 Aug 2007 (18 years ago) |
| Date of dissolution: | 28 Sep 2012 (12 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2012 (12 years ago) |
| Document Number: | L07000079226 |
| FEI/EIN Number | 260638789 |
| Address: | 11414 CYPRESS BAY STREET, CLERMONT, FL, 34711 |
| Mail Address: | 11414 CYPRESS BAY STREET, CLERMONT, FL, 34711 |
| ZIP code: | 34711 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265625990 | 2007-08-27 | 2023-03-07 | 1232 8TH ST, DAYTONA BEACH, FL, 321174009, US | 1232 8TH ST, DAYTONA BEACH, FL, 321174009, US | |||||||||||||||||||||||||||||||||||||||
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| Phone | +1 386-238-3777 |
| Fax | 3862383343 |
Authorized person
| Name | DENA FERMAN |
| Role | THIRD PARTY PLAN COORDINATOR |
| Phone | 3149936000 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| Is Primary | Yes |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | STATE LICENSE |
| Number | PH22899 |
| State | FL |
| Issuer | NCPDP |
| Number | 1028112 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| AGYEN KOFI | Agent | 11414 CYPRESS BAY STREET, CLERMONT, FL, 34711 |
| Name | Role | Address |
|---|---|---|
| AGYEN KOFI | Managing Member | 11414 CYPRESS BAY STREET, CLERMONT, FL, 34711 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-04-20 | 11414 CYPRESS BAY STREET, CLERMONT, FL 34711 | No data |
| CHANGE OF MAILING ADDRESS | 2011-04-20 | 11414 CYPRESS BAY STREET, CLERMONT, FL 34711 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2011-04-20 | 11414 CYPRESS BAY STREET, CLERMONT, FL 34711 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J11000432521 | LAPSED | 2010 30390 COCI | VOLUSIA COUNTY COURT | 2011-07-11 | 2016-07-15 | $15,819.91 | MASTERS PHARMACEUTICAL, INC., C/O WILLIAM M. LINDEMAN, P.A., POST OFFICE BOX 3506, ORLANDO, FL 32802 |
| J10001073276 | LAPSED | 2010-30426-CICI | CIR CRT VOLUSIA CNTY | 2010-11-09 | 2015-11-22 | $17261.68 | TOP RX, INC, 2950 BROTHER BOULEVARD, BARTLETT, TN 38133 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2011-04-20 |
| ANNUAL REPORT | 2010-04-26 |
| ANNUAL REPORT | 2009-02-17 |
| ANNUAL REPORT | 2008-05-21 |
| Florida Limited Liability | 2007-08-01 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
