| Entity Name: | PERIODONTAL ARTISTRY, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 27 Oct 2014 (10 years ago) |
| Document Number: | L14000167141 |
| FEI/EIN Number | 47-2197818 |
| Address: | 1281 Florida Ave S., Rockledge, FL, 32955, US |
| Mail Address: | 1281 Florida Ave S., Rockledge, FL, 32955, US |
| ZIP code: | 32955 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1861144214 | 2022-01-26 | 2022-01-26 | 1281 FLORIDA AVE S, ROCKLEDGE, FL, 329552439, US | 1281 FLORIDA AVE S, ROCKLEDGE, FL, 329552439, US | |||||||||||||
|
|||||||||||||||||
| Phone | +1 321-632-3171 |
Authorized person
| Name | DR. MOHAMAD ELAZIZI |
| Role | OWNER |
| Phone | 8106249432 |
Taxonomy
| Taxonomy Code | 1223P0300X - Periodontist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| ELAZIZI MOHAMAD | Agent | 1281 Florida Ave S., Rockledge, FL, 32955 |
| Name | Role | Address |
|---|---|---|
| Elazizi Mohamad Mohamad | Moha | 1281 Florida Ave S., Rockledge, FL, 32955 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-02-02 | 1281 Florida Ave S., Rockledge, FL 32955 | No data |
| CHANGE OF MAILING ADDRESS | 2022-02-02 | 1281 Florida Ave S., Rockledge, FL 32955 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-02-02 | 1281 Florida Ave S., Rockledge, FL 32955 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-21 |
| ANNUAL REPORT | 2023-04-05 |
| ANNUAL REPORT | 2022-02-02 |
| ANNUAL REPORT | 2021-04-08 |
| ANNUAL REPORT | 2020-06-15 |
| ANNUAL REPORT | 2019-04-14 |
| ANNUAL REPORT | 2018-02-11 |
| ANNUAL REPORT | 2017-02-23 |
| ANNUAL REPORT | 2016-04-16 |
| ANNUAL REPORT | 2015-03-19 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
