| Entity Name: | TAKA HEALTH, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 30 Jun 2011 (14 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 16 Feb 2012 (13 years ago) |
| Document Number: | L11000076150 |
| FEI/EIN Number | 452661189 |
| Address: | 1084 Lee Rd, Suite 4, Orlando, FL, 32810, US |
| Mail Address: | 1084 Lee Rd, Suite 4, Orlando, FL, 32810, US |
| ZIP code: | 32810 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1437423498 | 2012-03-08 | 2017-03-06 | 1084 LEE RD, SUITE 4, ORLANDO, FL, 328105821, US | 1084 LEE RD STE 4, ORLANDO, FL, 328105821, US | |||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 407-730-2770 |
| Fax | 4077302764 |
Authorized person
| Name | THANH-THUY NGUYEN |
| Role | PHARMACY MANAGER |
| Phone | 4077302770 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH25991 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336S0011X - Specialty Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | PK |
| Number | 2134152 |
| Issuer | MEDICAID |
| Number | 004619700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PAPAPANOS THEODOROS | Agent | 11753 CRESTRIDGE LOOP, NEW PORT RICHEY, FL, 34655 |
| Name | Role | Address |
|---|---|---|
| PAPAPANOS THEODOROS | Managing Member | 11753 CRESTRIDGE LOOP, NEW PORT RICHEY, FL, 34655 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-11-20 | PAPAPANOS, THEODOROS | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-11-20 | 11753 CRESTRIDGE LOOP, NEW PORT RICHEY, FL 34655 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-02-12 | 1084 Lee Rd, Suite 4, Orlando, FL 32810 | No data |
| CHANGE OF MAILING ADDRESS | 2013-02-12 | 1084 Lee Rd, Suite 4, Orlando, FL 32810 | No data |
| LC AMENDMENT | 2012-02-16 | No data | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-11-20 |
| ANNUAL REPORT | 2024-02-26 |
| ANNUAL REPORT | 2023-03-04 |
| ANNUAL REPORT | 2022-02-16 |
| ANNUAL REPORT | 2021-03-06 |
| ANNUAL REPORT | 2020-02-03 |
| ANNUAL REPORT | 2019-04-04 |
| ANNUAL REPORT | 2018-03-06 |
| ANNUAL REPORT | 2017-02-14 |
| ANNUAL REPORT | 2016-01-08 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
