| Entity Name: | GAYNAIR FAMILY MEDICINE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 20 Feb 2008 (17 years ago) |
| Document Number: | L08000018407 |
| FEI/EIN Number | 352326507 |
| Address: | 5700 Pine Terr, Plantation, FL, 33317, US |
| Mail Address: | 5700 Pine Terr, Plantation, FL, 33317, US |
| ZIP code: | 33317 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508032681 | 2008-05-07 | 2014-04-28 | 3330 SPANISH MOSS TER, 109, LAUDERHILL, FL, 333195058, US | 3330 SPANISH MOSS TER, 109, LAUDERHILL, FL, 333195058, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 216-496-5938 |
| Fax | 9545303138 |
Authorized person
| Name | DR. KAREN ANEITA GAYNAIR-SURRY |
| Role | PHYSICIAN |
| Phone | 2164965938 |
Taxonomy
| Taxonomy Code | 261QH0100X - Health Service Clinic/Center |
| License Number | ME94856 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 006618500 |
| State | FL |
| Issuer | MEDICAID |
| Number | 281403000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GAYNAIR KAREN ADr. | Agent | 5700 Pine Terr, Plantation, FL, 33317 |
| Name | Role | Address |
|---|---|---|
| GAYNAIR KAREN ADr. | President | 5700 Pine Terr, Plantation, FL, 33317 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2017-04-13 | GAYNAIR, KAREN Aneita, Dr. | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-04-05 | 5700 Pine Terr, Plantation, FL 33317 | No data |
| CHANGE OF MAILING ADDRESS | 2016-04-05 | 5700 Pine Terr, Plantation, FL 33317 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-04-05 | 5700 Pine Terr, Plantation, FL 33317 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-24 |
| ANNUAL REPORT | 2023-02-06 |
| ANNUAL REPORT | 2022-01-27 |
| ANNUAL REPORT | 2021-01-24 |
| ANNUAL REPORT | 2020-08-11 |
| ANNUAL REPORT | 2019-09-20 |
| ANNUAL REPORT | 2018-09-18 |
| ANNUAL REPORT | 2017-04-13 |
| ANNUAL REPORT | 2016-04-05 |
| ANNUAL REPORT | 2015-01-11 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
