| Entity Name: | MED-LAB COMPOUNDING, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 03 Mar 2014 (11 years ago) |
| Date of dissolution: | 25 Sep 2015 (9 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2015 (9 years ago) |
| Document Number: | L14000035361 |
| Address: | 9963 SW 142ND AVE, MIAMI, FL 33186 |
| Mail Address: | 9963 SW 142ND AVE, MIAMI, FL 33186 |
| ZIP code: | 33186 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538568803 | 2014-08-22 | 2014-11-20 | 9963 SW 142 AVE, MIAMI, FL, 33186, US | 9963 SW 142ND AVE, MIAMI, FL, 331866844, US | |||||||||||||||||||||||||
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| Phone | +1 786-534-7533 |
Authorized person
| Name | NEREYDA ROJAS |
| Role | TECHNICIAN |
| Phone | 7865347533 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| License Number | PH28330 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PK |
| Number | 2147240 |
| Name | Role | Address |
|---|---|---|
| PERDOMO, OSVALDO | Agent | 9963 SW 142ND AVE, MIAMI, FL 33186 |
| Name | Role | Address |
|---|---|---|
| ROJAS, NEREYDA | Manager | 9963 SW 142ND AVE, MIAMI, FL 33186 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G15000015971 | MED LAB PHARMACY & COMPOUND | EXPIRED | 2015-02-12 | 2020-12-31 | No data | 9963 SW 142 AVE, MIAMI, FL, 33186 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| LC STMNT OF RA/RO CHG | 2014-09-15 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2014-09-15 | PERDOMO, OSVALDO | No data |
| LC AMENDMENT | 2014-04-14 | No data | No data |
| Name | Date |
|---|---|
| CORLCRACHG | 2014-09-15 |
| LC Amendment | 2014-04-14 |
| Florida Limited Liability | 2014-03-03 |
Date of last update: 22 Jan 2025
Sources: Florida Department of State
