| Entity Name: | NONA DIAMOND DENTAL, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 08 Jan 2015 (10 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 29 Oct 2018 (6 years ago) |
| Document Number: | L15000004605 |
| FEI/EIN Number | 47-2737381 |
| Address: | 1696 S MILITARY TRAIL, UNIT #B, WEST PALM BEACH, FL, 33415, US |
| Mail Address: | 3517 SOUTH FEDERAL HWY, BOYNTON BEACH, FL, 33435, US |
| ZIP code: | 33415 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1437623154 | 2019-01-15 | 2019-01-15 | 1696 S MILITARY TRL UNIT B, WEST PALM BEACH, FL, 334155612, US | 1696 S MILITARY TRL UNIT B, WEST PALM BEACH, FL, 334155612, US | |||||||||||||||||||
|
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| Phone | +1 561-791-6494 |
Authorized person
| Name | ALI CORREA |
| Role | DENTIST |
| Phone | 5617916494 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 013781100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CORREA ALI | Agent | 3517 SOUTH FEDERAL HWY, BOYNTON BEACH, FL, 33435 |
| Name | Role | Address |
|---|---|---|
| CORREA ALI | Authorized Member | 3517 SOUTH FEDERAL HWY, BOYNTON BEACH, FL, 33435 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000027703 | NONA DENTAL | EXPIRED | 2019-02-27 | 2024-12-31 | No data | 3517 SOUTH FEDERAL HWY APT G, BOYNTON BEACH, FL, 33435 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2018-10-29 | 1696 S MILITARY TRAIL, UNIT #B, WEST PALM BEACH, FL 33415 | No data |
| LC AMENDMENT | 2018-10-29 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-10-21 | 3517 SOUTH FEDERAL HWY, G, BOYNTON BEACH, FL 33435 | No data |
| CHANGE OF MAILING ADDRESS | 2017-10-21 | 1696 S MILITARY TRAIL, UNIT #B, WEST PALM BEACH, FL 33415 | No data |
| REGISTERED AGENT NAME CHANGED | 2017-10-21 | CORREA, ALI | No data |
| REINSTATEMENT | 2017-10-21 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-27 |
| ANNUAL REPORT | 2023-05-01 |
| ANNUAL REPORT | 2022-05-01 |
| ANNUAL REPORT | 2021-05-01 |
| ANNUAL REPORT | 2020-06-30 |
| ANNUAL REPORT | 2019-05-01 |
| LC Amendment | 2018-10-29 |
| ANNUAL REPORT | 2018-05-01 |
| REINSTATEMENT | 2017-10-21 |
| ANNUAL REPORT | 2016-02-26 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
