| Entity Name: | LIFE SAVERX, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 05 Apr 2010 (15 years ago) |
| Date of dissolution: | 21 Jul 2022 (3 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 21 Jul 2022 (3 years ago) |
| Document Number: | L10000036236 |
| FEI/EIN Number | 272059121 |
| Address: | 207 EAST ROBERTSON STREET, BRANDON, FL, 33511, US |
| Mail Address: | 207 EAST ROBERTSON STREET, BRANDON, FL, 33511, US |
| ZIP code: | 33511 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013226687 | 2010-09-30 | 2011-02-04 | 207 E ROBERTSON ST, SUITE B, BRANDON, FL, 335115254, US | 207 E ROBERTSON ST STE B, BRANDON, FL, 335115254, US | |||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 813-283-1131 |
| Fax | 8134891789 |
Authorized person
| Name | RAFAEL CACERES |
| Role | CEO/OWNER |
| Phone | 8132831131 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | No |
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336H0001X - Home Infusion Therapy Pharmacy |
| License Number | PH24913 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 3336I0012X - Institutional Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336M0002X - Mail Order Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336S0011X - Specialty Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | NCPDP PROVIDER IDENTIFICATION NUMBER |
| Number | 5702077 |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LIFE SAVE RX LLC | 2021 | 272059121 | 2022-09-23 | LIFE SAVERX | 8 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2022-09-23 |
| Name of individual signing | RAFAEL CACERES |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2018-01-01 |
| Business code | 621399 |
| Sponsor’s telephone number | 8132831132 |
| Plan sponsor’s address | 207 E ROBERTSON ST STE B, BRANDON, FL, 33511 |
Signature of
| Role | Plan administrator |
| Date | 2022-09-23 |
| Name of individual signing | RAFAEL CACERES |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2018-01-01 |
| Business code | 621399 |
| Sponsor’s telephone number | 8132831132 |
| Plan sponsor’s address | 207 E ROBERTSON ST STE B, BRANDON, FL, 33511 |
Signature of
| Role | Plan administrator |
| Date | 2020-10-14 |
| Name of individual signing | KRISTY VELASQUEZ |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2018-01-01 |
| Business code | 621399 |
| Sponsor’s telephone number | 8132831132 |
| Plan sponsor’s address | 207 E ROBERTSON ST STE B, BRANDON, FL, 33511 |
Signature of
| Role | Plan administrator |
| Date | 2019-10-25 |
| Name of individual signing | KRISTY VELASQUEZ |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role |
|---|---|
| UNITED STATES CORPORATION AGENTS, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| Caceres Rafael RJr. | Authorized Member | 207 EAST ROBERTSON STREET, BRANDON, FL, 33511 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2023-02-02 | 476 RIVERSIDE AVE., JACKSONVILLE, FL 32202 | No data |
| VOLUNTARY DISSOLUTION | 2022-07-21 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2022-01-13 | UNITED STATES CORPORATION AGENTS, INC. | No data |
| CHANGE OF MAILING ADDRESS | 2021-10-13 | 207 EAST ROBERTSON STREET, SUITE B, BRANDON, FL 33511 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-10-13 | 207 EAST ROBERTSON STREET, SUITE B, BRANDON, FL 33511 | No data |
| LC DISSOCIATION MEM | 2021-06-23 | No data | No data |
| LC DISSOCIATION MEM | 2021-05-28 | No data | No data |
| LC DISSOCIATION MEM | 2021-05-24 | No data | No data |
| LC DISSOCIATION MEM | 2021-05-21 | No data | No data |
| LC AMENDMENT | 2017-06-07 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J23000338996 | ACTIVE | 501473-2022 | LEE CTY CIR CT 20TH JUD CIR | 2023-05-16 | 2028-07-21 | $344,514.63 | NEWCO CAPITAL GROUP VI LLC, 1 WHITEHALL STREET, SUITE 200, NEW YORK, NY 10004 |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2022-07-21 |
| ANNUAL REPORT | 2022-01-13 |
| AMENDED ANNUAL REPORT | 2021-10-13 |
| CORLCDSMEM | 2021-06-23 |
| AMENDED ANNUAL REPORT | 2021-06-03 |
| CORLCDSMEM | 2021-05-28 |
| CORLCDSMEM | 2021-05-24 |
| CORLCDSMEM | 2021-05-21 |
| ANNUAL REPORT | 2021-04-23 |
| ANNUAL REPORT | 2020-05-26 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
