| Entity Name: | MIAMI DADE PHYSICAL MEDICINE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 15 Jul 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: | L14000111602 |
| FEI/EIN Number | 47-1336610 |
| Address: | 331 NE 167TH STREET, NORTH MIAMI BEACH, FL 33162 |
| Mail Address: | PO BOX 15888, WEST PALM BEACH, FL 33416 |
| ZIP code: | 33162 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1659770055 | 2014-08-21 | 2014-08-21 | PO BOX 15888, WEST PALM BEACH, FL, 334165888, US | 331 NE 167TH ST, NORTH MIAMI BEACH, FL, 331622304, US | |||||||||||||||||
|
|||||||||||||||||||||
| Phone | +1 561-729-7092 |
| Phone | +1 305-947-6300 |
Authorized person
| Name | DR. RYAN A. GRAND |
| Role | PRESIDENT |
| Phone | 5617297092 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DAVI, ELIZABETH A | Agent | 7472 SAN CASTLE BLVD, LANTANA, FL 33462 |
| Name | Role | Address |
|---|---|---|
| GRAND, RYAN A | Manager | 1395 N. MILITARY TRAIL, WEST PALM BEACH, FL 33409 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G14000073640 | SOUTH FLORIDA SPINE AND REHAB CENTERS | EXPIRED | 2014-07-16 | 2019-12-31 | No data | PO BOX 15888, WEST PALM BEACH, FL, 33416 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| Name | Date |
|---|---|
| Florida Limited Liability | 2014-07-15 |
Date of last update: 21 Jan 2025
Sources: Florida Department of State
