| Entity Name: | MAAZALI LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 27 Jun 2011 (14 years ago) |
| Date of dissolution: | 29 Oct 2024 (3 months ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 29 Oct 2024 (3 months ago) |
| Document Number: | L11000074430 |
| FEI/EIN Number | 45-2632895 |
| Address: | 11451 CORTEZ BLVD, BROOKSVILLE, FL 34613 |
| Mail Address: | 11451 CORTEZ BLVD, BROOKSVILLE, FL 34613 |
| ZIP code: | 34613 |
| County: | Hernando |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1164693537 | 2008-03-13 | 2024-09-19 | 11451 CORTEZ BLVD, BROOKSVILLE, FL, 346137367, US | 14540 CORTEZ BLVD, SUITE # 116, BROOKSVILLE, FL, 346136056, US | |||||||||||||||||||||||||||
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| Phone | +1 352-797-9677 |
| Fax | 3526008913 |
| Fax | 3527979857 |
Authorized person
| Name | DR. SYED WAJAHAT ALI |
| Role | PRESIDENT |
| Phone | 3527979677 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME83482 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 264459200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ALI, SYED | Agent | 20809 lake vienna drive, land o lakes, FL 34638 |
| Name | Role | Address |
|---|---|---|
| ALI, SYED W | Manager | 20809 lake vienna drive, land o lakes, FL 34638 |
| NISHAT, SEEMA | Manager | 20809 lake vienna drive, land o lakes, FL 34638 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000094827 | BROOKSVILLE PRIMARY CARE | ACTIVE | 2024-08-09 | 2029-12-31 | No data | 11451 CORTEZ BLVD, BROOKSVILLE, FL, 34613 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2024-10-29 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-04-25 | 20809 lake vienna drive, land o lakes, FL 34638 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2014-06-11 | 11451 CORTEZ BLVD, BROOKSVILLE, FL 34613 | No data |
| CHANGE OF MAILING ADDRESS | 2014-06-11 | 11451 CORTEZ BLVD, BROOKSVILLE, FL 34613 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2024-10-29 |
| ANNUAL REPORT | 2024-02-10 |
| ANNUAL REPORT | 2023-02-16 |
| ANNUAL REPORT | 2022-01-29 |
| ANNUAL REPORT | 2021-02-07 |
| ANNUAL REPORT | 2020-02-25 |
| ANNUAL REPORT | 2019-03-24 |
| ANNUAL REPORT | 2018-01-11 |
| ANNUAL REPORT | 2017-07-07 |
| ANNUAL REPORT | 2016-04-25 |
Date of last update: 24 Jan 2025
Sources: Florida Department of State
