| Entity Name: | RIVIERA PLAZA MEDICAL OFFICE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
RIVIERA PLAZA MEDICAL OFFICE 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: | 08 Oct 2013 (12 years ago) |
| Date of dissolution: | 31 Dec 2019 (5 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 31 Dec 2019 (5 years ago) |
| Document Number: | L13000141537 |
| FEI/EIN Number |
46-3916469
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 1702 RIDGEWOOD AVE, SUITE I, HOLLY HILL, FL, 32117, US |
| Mail Address: | 1702 RIDGEWOOD AVE, SUITE I, HOLLY HILL, FL, 32117, US |
| ZIP code: | 32117 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013338144 | 2013-12-16 | 2014-04-23 | 208 N HALIFAX AVE, SUITE1, DAYTONA BEACH, FL, 321184159, US | 1702 RIDGEWOOD AVE, SUITE I, HOLLY HILL, FL, 321175416, US | |||||||||||||||||||||||||||||||
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| Phone | +1 386-677-5415 |
| Fax | 3866771475 |
Authorized person
| Name | DR. GLORIA HELEN MIKULA |
| Role | MEDICAL DIRECTOR |
| Phone | 3866775415 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | ME47765 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 042193600 |
| State | FL |
| Issuer | MEDICARE PTAN |
| Number | HS776A |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MIKULA GLORIA HMD | Manager | 1702 RIDGEWOOD AVE SUITE I, HOLLY HILL, FL, 32117 |
| GLORIA MIKULA HMD | Agent | 208 NORTH HALIFAX AVE, DAYTONA BEACH, FL, 32118 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2019-12-31 | - | - |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2019-12-31 |
| ANNUAL REPORT | 2019-03-31 |
| ANNUAL REPORT | 2018-03-26 |
| ANNUAL REPORT | 2017-03-31 |
| ANNUAL REPORT | 2016-03-14 |
| ANNUAL REPORT | 2015-04-20 |
| ANNUAL REPORT | 2014-04-21 |
| Florida Limited Liability | 2013-10-08 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
