| Entity Name: | MAJESTY MEDICAL ASSOCIATES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 25 Feb 2013 (12 years ago) |
| Date of dissolution: | 28 Sep 2018 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2018 (6 years ago) |
| Document Number: | L13000029173 |
| FEI/EIN Number | 462118913 |
| Address: | 1447 Medical Park Blvd Suite 405, WELLINGTON, FL, 33414, US |
| Mail Address: | 1447 Medical Park Blvd Suite 405, WELLINGTON, FL, 33414, US |
| ZIP code: | 33414 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1447694948 | 2013-04-26 | 2014-11-12 | 9696 PHIPPS LN, WELLINGTON, FL, 334143404, US | 1447 MEDICAL PARK BLVD, SUITE 405, WELLINGTON, FL, 334143164, US | |||||||||||||||||||||||
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| Phone | +1 561-267-4701 |
| Phone | +1 561-792-7454 |
| Fax | 5617927488 |
Authorized person
| Name | DR. PEDRO NAM |
| Role | DIRECTOR |
| Phone | 5617927454 |
Taxonomy
| Taxonomy Code | 207RA0000X - Adolescent Medicine (Internal Medicine) Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 010046601 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| NAM PEDRO | Agent | 9696 PHIPPS LANE, WELLINGTON, FL, 33449 |
| Name | Role | Address |
|---|---|---|
| NAM PEDRO | Managing Member | 9696 PHIPPS LANE, WELLINGTON, FL, 33449 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2014-04-01 | 1447 Medical Park Blvd Suite 405, WELLINGTON, FL 33414 | No data |
| CHANGE OF MAILING ADDRESS | 2014-04-01 | 1447 Medical Park Blvd Suite 405, WELLINGTON, FL 33414 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-02-27 |
| ANNUAL REPORT | 2016-02-18 |
| ANNUAL REPORT | 2015-02-06 |
| ANNUAL REPORT | 2014-04-01 |
| Florida Limited Liability | 2013-02-25 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
