| Entity Name: | BERMUDA PHARMACY #1, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 30 Jun 2014 (11 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 21 Jul 2020 (5 years ago) |
| Document Number: | L14000103941 |
| FEI/EIN Number | 47-1225801 |
| Address: | 8702 PROVIDENCE CT, MOUNT DORA, FL, 32757, US |
| Mail Address: | 8702 PROVIDENCE CT, MOUNT DORA, FL, 32757, US |
| ZIP code: | 32757 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508250465 | 2015-03-27 | 2015-03-27 | 393 PALM DR, ISLAMORADA, FL, 330364212, US | 393 PALM DR, ISLAMORADA, FL, 330364212, US | |||||||||||||||||||
|
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| Phone | +1 305-903-8092 |
| Fax | 3056470263 |
Authorized person
| Name | DR. NICHOLAS JASTRZEMSKI |
| Role | PHARMACY MANAGER (PDM/ P.I.C.) |
| Phone | 3059038092 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| License Number | PS0040188 |
| State | FL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| NORTHWEST REGISTERED AGENT LLC | Agent |
| Name | Role | Address |
|---|---|---|
| JASTRZEMSKI NICHOLAS | Manager | 8702 PROVIDENCE CT, MOUNT DORA, FL, 32757 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G14000067766 | AGUA VIVA PHARMACY | EXPIRED | 2014-06-30 | 2019-12-31 | No data | 393 PALM DR, ISLAMORADA, FL, 33036 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-06-05 | 8702 PROVIDENCE CT, MOUNT DORA, FL 32757 | No data |
| CHANGE OF MAILING ADDRESS | 2021-06-05 | 8702 PROVIDENCE CT, MOUNT DORA, FL 32757 | No data |
| LC STMNT OF RA/RO CHG | 2020-07-21 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2020-07-21 | NORTHWEST REGISTERED AGENT LLC | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-07-21 | 7901 4TH ST N STE 300, ST. PETERSBURG, FL 33702 | No data |
| LC STMNT OF RA/RO CHG | 2019-06-26 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-11 |
| ANNUAL REPORT | 2023-01-06 |
| ANNUAL REPORT | 2022-01-06 |
| AMENDED ANNUAL REPORT | 2021-06-05 |
| ANNUAL REPORT | 2021-01-22 |
| CORLCRACHG | 2020-07-21 |
| ANNUAL REPORT | 2020-01-28 |
| AMENDED ANNUAL REPORT | 2019-06-27 |
| CORLCRACHG | 2019-06-26 |
| ANNUAL REPORT | 2019-03-18 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
