| Entity Name: | MANGO PHARMACY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 14 Aug 2015 (9 years ago) |
| Date of dissolution: | 27 Sep 2024 (4 months ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2024 (4 months ago) |
| Document Number: | L15000139506 |
| FEI/EIN Number | 37-1790517 |
| Mail Address: | 5908 Breckenridge Pkwy, TAMPA, FL, 33610, US |
| Address: | 11509 E MLK Jr. Blvd, Mango, FL, 33550, US |
| ZIP code: | 33550 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1669785168 | 2010-07-26 | 2021-07-09 | 11509 DR. MARTIN LUTHER KING JR. BLVD, MANGO, FL, 33550, US | 11509 DR MARTIN LUTHER KING JR BLVD, MANGO, FL, 33550, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 813-661-2263 |
| Fax | 8136622263 |
Authorized person
| Name | ALPESH PATEL |
| Role | OWNER |
| Phone | 8136612263 |
Taxonomy
| Taxonomy Code | 163WD0400X - Diabetes Educator Registered Nurse |
| Is Primary | No |
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH29956 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 017041900 |
| State | FL |
| Issuer | PK |
| Number | 2158271 |
| Name | Role | Address |
|---|---|---|
| PATEL ALPESH | Agent | 5908 BRECKENRIDGE PRKWY, TAMPA, FL, 33610 |
| Name | Role | Address |
|---|---|---|
| PATEL ALPESH | Manager | 5908 BRECKENRIDGE PKWY, TAMPA, FL, 33610 |
| PATEL MANISH | Manager | 5908 BRECKENRIDGE PKWY, TAMPA, FL, 33610 |
| Name | Role |
|---|---|
| BENZER PHARMACY HOLDING LLC | Authorized Member |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000066963 | MANGO PHARMACY | ACTIVE | 2020-06-15 | 2025-12-31 | No data | 5908 BRECKENRIDGE PARKWAY, TAMPA, FL, 33610 |
| G16000001722 | BENZER PHARMACY 156 | EXPIRED | 2016-01-05 | 2021-12-31 | No data | 125 W. COUNTRY CLUB DR, TAMPA, FL, 33612 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2020-10-05 | PATEL, ALPESH | No data |
| LC STMNT OF RA/RO CHG | 2020-10-05 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-10-05 | 5908 BRECKENRIDGE PRKWY, TAMPA, FL 33610 | No data |
| LC NAME CHANGE | 2020-06-15 | MANGO PHARMACY LLC | No data |
| LC AMENDMENT | 2018-10-08 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2017-03-21 | 11509 E MLK Jr. Blvd, Mango, FL 33550 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2017-03-21 | 11509 E MLK Jr. Blvd, Mango, FL 33550 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2023-04-27 |
| ANNUAL REPORT | 2022-04-27 |
| ANNUAL REPORT | 2021-04-07 |
| CORLCRACHG | 2020-10-05 |
| ANNUAL REPORT | 2020-06-26 |
| LC Name Change | 2020-06-15 |
| ANNUAL REPORT | 2019-02-20 |
| LC Amendment | 2018-10-08 |
| ANNUAL REPORT | 2018-04-14 |
| ANNUAL REPORT | 2017-03-21 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
