| Entity Name: | MANATEE ORAL AND FACIAL SURGERY CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 04 Mar 2009 (16 years ago) |
| Document Number: | L09000021161 |
| FEI/EIN Number | 264374895 |
| Address: | 5460 LENA ROAD, UNIT # 102, BRADENTON, FL, 34211 |
| Mail Address: | 5460 LENA ROAD, UNIT # 102, BRADENTON, FL, 34211 |
| ZIP code: | 34211 |
| County: | Manatee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811138662 | 2009-03-07 | 2009-03-09 | 5460 LENA RD, UNIT 102, BRADENTON, FL, 342119500, US | 5460 LENA RD, UNIT 102, BRADENTON, FL, 342119500, US | |||||||||||||||||||||||||
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| Phone | +1 502-644-7833 |
| Fax | 9414927184 |
Authorized person
| Name | PRASHANT PANDYA |
| Role | OWNER |
| Phone | 5026447833 |
Taxonomy
| Taxonomy Code | 1223S0112X - Oral and Maxillofacial Surgery (Dentist) |
| License Number | DN17268 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAL LICENSE |
| Number | DN17268 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MANATEE ORAL AND FACIAL SURGERY CENTER, LLC CASH BALANCE PENSION PLAN | 2023 | 264374895 | 2024-08-30 | MANATEE ORAL AND FACIAL SURGERY CENTER, LLC | 4 | |||||||||||||
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| MANATEE ORAL AND FACIAL SURGERY CENTER, LLC CASH BALANCE PENSION PLAN | 2022 | 264374895 | 2023-10-13 | MANATEE ORAL AND FACIAL SURGERY CENTER, LLC | 4 | |||||||||||||
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| Name | Role | Address |
|---|---|---|
| PANDYA PRASHANT R | Agent | 5460 LENA ROAD, BRADENTON, FL, 34211 |
| Name | Role | Address |
|---|---|---|
| PANDYA PRASHANT R | Manager | 5460 LENA ROAD, SUITE 102, BRADENTON, FL, 34211 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2010-01-09 | 5460 LENA ROAD, UNIT # 102, BRADENTON, FL 34211 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-01-09 | 5460 LENA ROAD, 102, BRADENTON, FL 34211 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-08 |
| ANNUAL REPORT | 2023-03-08 |
| ANNUAL REPORT | 2022-03-30 |
| ANNUAL REPORT | 2021-03-12 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-03-08 |
| ANNUAL REPORT | 2018-02-28 |
| ANNUAL REPORT | 2017-03-02 |
| ANNUAL REPORT | 2016-03-03 |
| ANNUAL REPORT | 2015-03-12 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
