| Entity Name: | NEISA I. DIAZ, M.D., LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
NEISA I. DIAZ, M.D., LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 18 Jun 2013 (12 years ago) |
| Date of dissolution: | 23 Sep 2022 (3 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (3 years ago) |
| Document Number: | L13000087865 |
| FEI/EIN Number |
35-2481187
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 13501 ICOT BLVD., SUITE 114, CLEARWATER, FL, 33760, US |
| Mail Address: | 13501 ICOT BLVD., SUITE 114, CLEARWATER, FL, 33760, US |
| ZIP code: | 33760 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1659713261 | 2013-07-24 | 2013-07-24 | 13501 ICOT BLVD, SUITE 114, CLEARWATER, FL, 337603729, US | 13501 ICOT BLVD, SUITE 114, CLEARWATER, FL, 337603729, US | |||||||||||||||||||||||||
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| Phone | +1 727-754-7880 |
| Fax | 7277547885 |
Authorized person
| Name | NEISA I DIAZ |
| Role | OWNER |
| Phone | 7277547880 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | 97050 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 277721500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DIAZ NEISA I | Manager | 13501 ICOT BLVD., CLEARWATER, FL, 33760 |
| Diaz Neisa IM.D. | Agent | 13501 ICOT BLVD, CLEARWATER, FL, 337603729 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | - | - |
| REGISTERED AGENT NAME CHANGED | 2019-05-01 | Diaz, Neisa I, M.D. | - |
| REGISTERED AGENT ADDRESS CHANGED | 2017-01-19 | 13501 ICOT BLVD, SUITE 114, CLEARWATER, FL 33760-3729 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2021-02-17 |
| ANNUAL REPORT | 2020-04-07 |
| ANNUAL REPORT | 2019-05-01 |
| ANNUAL REPORT | 2018-02-09 |
| ANNUAL REPORT | 2017-01-19 |
| ANNUAL REPORT | 2016-03-31 |
| ANNUAL REPORT | 2015-03-04 |
| ANNUAL REPORT | 2014-03-20 |
| Florida Limited Liability | 2013-06-18 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 4581467401 | 2020-05-10 | 0455 | PPP | 13501 ICOT BLVD STE 114, CLEARWATER, FL, 33760-3729 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Apr 2025
Sources: Florida Department of State
