| Entity Name: | GOLDTREE RX L.L.C |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 27 Sep 2011 (13 years ago) |
| Date of dissolution: | 23 Sep 2016 (8 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2016 (8 years ago) |
| Document Number: | L11000110740 |
| FEI/EIN Number | 45-5577106 |
| Address: | 1401 SE GOLDTREE DR, # 103, PORT ST LUCIE, FL 34952 |
| Mail Address: | 4625 103RD AVE, SUNRISE, FL 33351 |
| ZIP code: | 34952 |
| County: | St. Lucie |
| Place of Formation: | FLORIDA |
| Type | Company Name | Company Number | State |
|---|---|---|---|
| Headquarter of | GOLDTREE RX L.L.C, ILLINOIS | LLC_04794028 | ILLINOIS |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1740530013 | 2012-09-14 | 2012-11-13 | 1401 SE GOLDTREE DR, UNIT 103, PORT ST LUCIE, FL, 349527584, US | 1401 SE GOLDTREE DR STE 103, PORT ST LUCIE, FL, 349527584, US | |||||||||||||||||||||||||
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| Phone | +1 772-237-4426 |
Authorized person
| Name | TOMA TOBIA |
| Role | PHARMACIST/MANAGER |
| Phone | 2818274652 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| License Number | PH26113 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NCPDP PROVIDER IDENTIFICATION NUMBER |
| Number | 5711773 |
| Name | Role | Address |
|---|---|---|
| DIETERLE, GORDON A, ESQ | Agent | 2101 NW CORPORATE BLVD, STE 400, BOCA RATON, FL 33432 |
| Name | Role | Address |
|---|---|---|
| GIL, EDUARDO | Manager | 4625 103RD AVE, SUNRISE, FL 33351 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G11000098492 | HILLMOOR PHARMACY | EXPIRED | 2011-10-06 | 2016-12-31 | No data | 1401 GOLDTREE DRIVE, PORT ST. LUCIE, FL, 34529 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| LC AMENDMENT | 2014-02-10 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-12-11 | 2101 NW CORPORATE BLVD, STE 400, BOCA RATON, FL 33432 | No data |
| LC AMENDMENT | 2013-12-11 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2013-12-11 | 1401 SE GOLDTREE DR, # 103, PORT ST LUCIE, FL 34952 | No data |
| REGISTERED AGENT NAME CHANGED | 2013-12-11 | DIETERLE, GORDON A, ESQ | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-12-11 | 1401 SE GOLDTREE DR, # 103, PORT ST LUCIE, FL 34952 | No data |
| REINSTATEMENT | 2013-10-07 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2015-04-17 |
| LC Amendment | 2014-02-10 |
| ANNUAL REPORT | 2014-02-04 |
| LC Amendment | 2013-12-11 |
| REINSTATEMENT | 2013-10-07 |
| ANNUAL REPORT | 2012-01-05 |
| Florida Limited Liability | 2011-09-27 |
Date of last update: 24 Jan 2025
Sources: Florida Department of State
