| Entity Name: | MASSARA MEDICAL CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 22 Jan 2014 (11 years ago) |
| Document Number: | L14000012137 |
| FEI/EIN Number | 46-4593257 |
| Address: | 455 NE 5TH AVE, SUITE D - 297, DELRAY BEACH, FL 33483 |
| Mail Address: | 651 Marina Point Drive, Daytona Beach, FL 32114 |
| ZIP code: | 33483 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1417370784 | 2014-01-22 | 2014-01-22 | 455 NE 5TH AVE, SUITE D -297, DELRAY BEACH, FL, 334835658, US | 455 NE 5TH AVE, SUITE D -297, DELRAY BEACH, FL, 334835658, US | |||||||||||||||||
|
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| Phone | +1 772-233-9515 |
Authorized person
| Name | DR. LORETHA KING |
| Role | CEO/CMO |
| Phone | 7722339515 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| License Number | OS8310 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| KING, LORETHA, DO,MBA | Agent | 651 Marina Point Drive, Daytona Beach, FL 32115 |
| Name | Role | Address |
|---|---|---|
| King, Loretha, DO,MBA | Principle | 455 NE 5TH AVE, SUITE D - 297 DELRAY BEACH, FL 33483 |
| Name | Role | Address |
|---|---|---|
| King, Loretha, DO,MBA | Owner | 455 NE 5TH AVE, SUITE D - 297 DELRAY BEACH, FL 33483 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2023-03-24 | 455 NE 5TH AVE, SUITE D - 297, DELRAY BEACH, FL 33483 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-03-24 | 651 Marina Point Drive, Daytona Beach, FL 32115 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-04 |
| ANNUAL REPORT | 2023-03-24 |
| ANNUAL REPORT | 2022-02-12 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-04-16 |
| ANNUAL REPORT | 2019-03-26 |
| ANNUAL REPORT | 2018-03-16 |
| ANNUAL REPORT | 2017-04-25 |
| ANNUAL REPORT | 2016-04-27 |
| ANNUAL REPORT | 2015-03-11 |
Date of last update: 21 Feb 2025
Sources: Florida Department of State
