| Entity Name: | PEDIATRIC CARE OF FOUR CORNERS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 01 Aug 2014 (11 years ago) |
| Last Event: | LC NAME CHANGE |
| Event Date Filed: | 14 Jan 2025 (20 days ago) |
| Document Number: | L14000121177 |
| FEI/EIN Number | 47-1641834 |
| Address: | 2516 SAND MINE ROAD, DAVENPORT, FL 33897 |
| Mail Address: | 2516 SAND MINE ROAD, DAVENPORT, FL 33897 |
| ZIP code: | 33897 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1790185981 | 2014-08-26 | 2014-08-26 | 2506 SAND MINE RD, DAVENPORT, FL, 338973402, US | 2506 SAND MINE RD, DAVENPORT, FL, 338973402, US | |||||||||||||
|
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| Phone | +1 863-232-5527 |
Authorized person
| Name | EIMAN EL SAYED |
| Role | OWNER |
| Phone | 8632325527 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| YONGE, L. TYLER | Agent | 6987 EAST FOWLER AVENUE, TAMPA, FL 33617 |
| Name | Role | Address |
|---|---|---|
| ELSAYED, EIMAN | Manager | 2508 SAND MINE ROAD, DAVENPORT, FL 33897 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC NAME CHANGE | 2025-01-14 | PEDIATRIC CARE OF FOUR CORNERS, LLC | No data |
| REGISTERED AGENT NAME CHANGED | 2025-01-14 | YONGE, L. TYLER | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2025-01-14 | 6987 EAST FOWLER AVENUE, TAMPA, FL 33617 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-10-20 | 2516 SAND MINE ROAD, DAVENPORT, FL 33897 | No data |
| CHANGE OF MAILING ADDRESS | 2021-10-20 | 2516 SAND MINE ROAD, DAVENPORT, FL 33897 | No data |
| LC NAME CHANGE | 2014-08-15 | PEDIATRIC CARE OF FOUR CORNERS, PLLC | No data |
| Name | Date |
|---|---|
| LC Name Change | 2025-01-14 |
| ANNUAL REPORT | 2024-01-25 |
| AMENDED ANNUAL REPORT | 2023-04-25 |
| ANNUAL REPORT | 2023-01-18 |
| AMENDED ANNUAL REPORT | 2022-05-01 |
| ANNUAL REPORT | 2022-01-12 |
| ANNUAL REPORT | 2021-01-12 |
| ANNUAL REPORT | 2020-01-12 |
| ANNUAL REPORT | 2019-01-14 |
| ANNUAL REPORT | 2018-03-26 |
Date of last update: 21 Jan 2025
Sources: Florida Department of State
