| Entity Name: | ADVANCED ORTHODONTICS OF AMERICA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 01 Jul 2013 (12 years ago) |
| Document Number: | L13000094469 |
| FEI/EIN Number | 46-3248993 |
| Address: | 2202 State Ave, Suite 200, PANAMA CITY, FL, 32405, US |
| Mail Address: | 9387 Paradise Dr, Panama City Beach, FL, 32413, US |
| ZIP code: | 32405 |
| County: | Bay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881137842 | 2016-11-23 | 2016-11-23 | 2202 STATE AVE STE 200, PANAMA CITY, FL, 324054582, US | 2202 STATE AVE STE 200, PANAMA CITY, FL, 324054582, US | |||||||||||||||||||||||
|
|||||||||||||||||||||||||||
| Phone | +1 850-769-2722 |
Authorized person
| Name | LAUREN KOVALESKI |
| Role | MANAGER |
| Phone | 8507692722 |
Taxonomy
| Taxonomy Code | 1223X0400X - Orthodontics and Dentofacial Orthopedic Dentist |
| License Number | DN19214 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 007329900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| KOVALESKI LAUREN | Agent | 2202 State Ave, Suite 200, PANAMA CITY, FL, 32405 |
| Name | Role | Address |
|---|---|---|
| KOVALESKI LAUREN | Manager | 2202 State Ave, Suite 200, PANAMA CITY, FL, 32405 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2025-01-09 | 2202 State Ave, Suite 200, PANAMA CITY, FL 32405 | No data |
| CHANGE OF MAILING ADDRESS | 2019-01-05 | 2202 State Ave, Suite 200, PANAMA CITY, FL 32405 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-01-26 | 2202 State Ave, Suite 200, PANAMA CITY, FL 32405 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-01-26 | 2202 State Ave, Suite 200, PANAMA CITY, FL 32405 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-20 |
| ANNUAL REPORT | 2024-01-22 |
| ANNUAL REPORT | 2023-01-29 |
| ANNUAL REPORT | 2022-01-28 |
| ANNUAL REPORT | 2021-01-22 |
| ANNUAL REPORT | 2020-01-16 |
| ANNUAL REPORT | 2019-01-05 |
| ANNUAL REPORT | 2018-01-12 |
| ANNUAL REPORT | 2017-01-09 |
| ANNUAL REPORT | 2016-03-09 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
