| Entity Name: | PHYSICIAN PRACTICES OF MSMC, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 24 Mar 2011 (14 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 14 Dec 2020 (4 years ago) |
| Document Number: | L11000035935 |
| FEI/EIN Number | 451154796 |
| Address: | 4300 ALTON ROAD, WARNER BUILDING FIFTH FLOOR, MIAMI BEACH, FL, 33140, US |
| Mail Address: | 4300 ALTON ROAD, WARNER BUILDING FIFTH FLOOR, MIAMI BEACH, FL, 33140, US |
| ZIP code: | 33140 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1356630628 | 2011-04-07 | 2021-03-31 | P.O. BOX 403429, MIAMI BEACH, FL, 331401429, US | 4302 ALTON RD, SUITE 830, MIAMI BEACH, FL, 331402891, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 305-674-2841 |
| Fax | 3035357919 |
| Phone | +1 305-674-2404 |
| Fax | 3056742544 |
Authorized person
| Name | MR. WAYNE CHUTKAN |
| Role | VP OF FINACE |
| Phone | 3056742662 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 207RE0101X - Endocrinology, Diabetes & Metabolism Physician |
| Is Primary | No |
| Taxonomy Code | 207RG0100X - Gastroenterology Physician |
| Is Primary | No |
| Taxonomy Code | 207T00000X - Neurological Surgery Physician |
| License Number | ME36383 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 2080N0001X - Neonatal-Perinatal Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 2084N0400X - Neurology Physician |
| Is Primary | No |
| Taxonomy Code | 2085R0204X - Vascular & Interventional Radiology Physician |
| Is Primary | No |
| Taxonomy Code | 208G00000X - Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| Is Primary | No |
| Taxonomy Code | 208VP0000X - Pain Medicine Physician |
| License Number | ME388396 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| YAP VALERIE | Agent | 4300 ALTON ROAD, MIAMI BEACH, FL, 33140 |
| Name | Role |
|---|---|
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC. | Managing Member |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC STMNT OF RA/RO CHG | 2020-12-14 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2020-12-14 | YAP, VALERIE | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-12 |
| ANNUAL REPORT | 2023-02-28 |
| ANNUAL REPORT | 2022-04-05 |
| ANNUAL REPORT | 2021-03-04 |
| CORLCRACHG | 2020-12-14 |
| ANNUAL REPORT | 2020-02-05 |
| ANNUAL REPORT | 2019-04-04 |
| ANNUAL REPORT | 2018-02-05 |
| ANNUAL REPORT | 2017-01-23 |
| ANNUAL REPORT | 2016-03-07 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
