| Entity Name: | A&B PEDIATRIC DENTISTS LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 17 Oct 2014 (10 years ago) |
| Document Number: | L14000162026 |
| FEI/EIN Number | 47-2181384 |
| Address: | 6370 N State Road 7, Suite 115, Coconut Creek, FL 33073 |
| Mail Address: | 6370 N State Road 7, Suite 115, Coconut Creek, FL 33073 |
| ZIP code: | 33073 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1871975813 | 2015-06-26 | 2015-06-26 | 6370 N STATE ROAD 7, SUITE 115, COCONUT CREEK, FL, 330733606, US | 6370 N STATE ROAD 7, SUITE 115, COCONUT CREEK, FL, 330733606, US | |||||||||||||||||||||
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| Phone | +1 954-866-4223 |
| Fax | 8446357210 |
Authorized person
| Name | RICARDO MAJKA |
| Role | MANAGER |
| Phone | 7879090350 |
Taxonomy
| Taxonomy Code | 1223P0221X - Pediatric Dentist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 014041800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Aguilar, Liza M | Agent | 6370 N State Road 7, Suite 115, Coconut Creek, FL 33073 |
| Name | Role | Address |
|---|---|---|
| AGUILAR, LIZA M | President | 6171 NW 77th terrace, parkland, FL 33067 |
| Name | Role | Address |
|---|---|---|
| BARBA, ERICA E | Vice President | 451 SW 15TH DRIVE, BOCA RATON, FL 33432 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G15000042884 | A&B PEDIATRIC DENTISTRY | EXPIRED | 2015-04-29 | 2020-12-31 | No data | 3381 SW 195TH TERRACE, MIRAMAR, FL, 33029 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2018-01-15 | 6370 N State Road 7, Suite 115, Coconut Creek, FL 33073 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2017-03-15 | 6370 N State Road 7, Suite 115, Coconut Creek, FL 33073 | No data |
| CHANGE OF MAILING ADDRESS | 2017-03-15 | 6370 N State Road 7, Suite 115, Coconut Creek, FL 33073 | No data |
| REGISTERED AGENT NAME CHANGED | 2015-04-29 | Aguilar, Liza M | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-02-05 |
| ANNUAL REPORT | 2024-05-01 |
| ANNUAL REPORT | 2023-04-20 |
| ANNUAL REPORT | 2022-06-06 |
| ANNUAL REPORT | 2021-03-16 |
| ANNUAL REPORT | 2020-01-08 |
| ANNUAL REPORT | 2019-01-28 |
| ANNUAL REPORT | 2018-01-15 |
| ANNUAL REPORT | 2017-03-15 |
| ANNUAL REPORT | 2016-02-23 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 8858168305 | 2021-01-30 | 0455 | PPS | 6370 N State Road 7 Ste 115, Coconut Creek, FL, 33073-3614 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 20 Feb 2025
Sources: Florida Department of State
