| Entity Name: | RX FLORIDA PHARMACY,LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 30 Jun 2014 (11 years ago) |
| Date of dissolution: | 27 Sep 2024 (5 months ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2024 (5 months ago) |
| Document Number: | L14000103982 |
| FEI/EIN Number | 47-1557674 |
| Mail Address: | 3615 COLUMBIA ST, ORLANDO, FL 32805 |
| Address: | 3615 COLUMBIA STREET, ORLANDO, FL 32805 |
| ZIP code: | 32805 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1750772612 | 2015-02-13 | 2022-11-25 | 155 SAGECREST DR, OCOEE, FL, 347614602, US | 3615 COLUMBIA ST, ORLANDO, FL, 32805, US | |||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 407-704-6422 |
| Fax | 4077046322 |
Authorized person
| Name | MR. GIRMA BIRU HURESAE |
| Role | PHARMACIST IN CHARGE |
| Phone | 4077046422 |
Taxonomy
| Taxonomy Code | 183500000X - Pharmacist |
| License Number | PH28826 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| Is Primary | Yes |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH28826 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 014580000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Mabifa, Tope K | Agent | 155 SAGE CREST DR, OCOEE, FL 34761 |
| Name | Role | Address |
|---|---|---|
| Mabifa, Tope K | Manager | 3615 COLUMBIA ST, ORLANDO, FL 32805 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2023-07-13 | 3615 COLUMBIA STREET, ORLANDO, FL 32805 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-07-13 | Mabifa, Tope K | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-01-10 | 3615 COLUMBIA STREET, ORLANDO, FL 32805 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2023-07-13 |
| ANNUAL REPORT | 2022-02-07 |
| ANNUAL REPORT | 2021-02-10 |
| ANNUAL REPORT | 2020-03-30 |
| ANNUAL REPORT | 2019-01-10 |
| ANNUAL REPORT | 2018-03-16 |
| ANNUAL REPORT | 2017-01-30 |
| ANNUAL REPORT | 2016-02-05 |
| ANNUAL REPORT | 2015-01-07 |
| Florida Limited Liability | 2014-06-30 |
Date of last update: 20 Feb 2025
Sources: Florida Department of State
