| Entity Name: | MAKTINA LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 04 Sep 2015 (9 years ago) |
| Date of dissolution: | 15 Jan 2018 (7 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 15 Jan 2018 (7 years ago) |
| Document Number: | L15000152354 |
| FEI/EIN Number | 47-4981912 |
| Address: | 4012 SAWYER ROAD, SARASOTA, FL 34233 |
| Mail Address: | 3318 FAIRLANE FARMS ROAD, WELLINGTON, FL 33414 |
| ZIP code: | 34233 |
| County: | Sarasota |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1861885170 | 2015-03-11 | 2015-11-05 | 4012 SAWYER RD, SUITE# 107, SARASOTA, FL, 342331231, US | 4012 SAWYER RD, SUITE# 107, SARASOTA, FL, 342331231, US | |||||||||||||||||||||||
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| Phone | +1 941-552-6054 |
Authorized person
| Name | DR. CHRISTINE KADOUS |
| Role | OWNER |
| Phone | 9415526054 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH29485 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 013655600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GIRGIS, DENISE | Agent | 1052 S Powerline Road, Deerfield Beach, FL 33442 |
| Name | Role | Address |
|---|---|---|
| GIRGIS, DENISE | PRESIDENT | 1052 S POWERLINE ROAD, DEERFIELD BEACH, FL 33442 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000007254 | ST. SIMON PHARMACY | EXPIRED | 2016-01-20 | 2021-12-31 | No data | 4012 SAWYER ROAD, SARASOTA, FL, 34233 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2018-01-15 | No data | No data |
| LC AMENDMENT | 2016-11-22 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2016-11-22 | 4012 SAWYER ROAD, SARASOTA, FL 34233 | No data |
| REGISTERED AGENT NAME CHANGED | 2016-11-22 | GIRGIS, DENISE | No data |
| REINSTATEMENT | 2016-10-24 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-10-24 | 1052 S Powerline Road, Deerfield Beach, FL 33442 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-01-27 |
| LC Amendment | 2016-11-22 |
| REINSTATEMENT | 2016-10-24 |
| Florida Limited Liability | 2015-09-04 |
Date of last update: 20 Jan 2025
Sources: Florida Department of State
