| Entity Name: | THE DIABETES AND ENDOCRINE CENTER OF PENSACOLA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 19 Nov 2015 (9 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 13 Nov 2017 (7 years ago) |
| Document Number: | L15000196113 |
| FEI/EIN Number | 81-0684322 |
| Address: | 6160 N Davis Hwy, PENSACOLA, FL, 32504, US |
| Mail Address: | 9008 ASHVILLE DRIVE, PENSACOLA, FL, 32514, US |
| ZIP code: | 32504 |
| County: | Escambia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811354129 | 2016-01-19 | 2016-11-02 | 6160 N DAVIS HWY, SUITE 10A, PENSACOLA, FL, 325046994, US | 6160 N DAVIS HWY, SUITE 10A, PENSACOLA, FL, 325046994, US | |||||||||||||||||||||||||||
|
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| Phone | +1 850-208-3848 |
| Fax | 8504760602 |
| Fax | 8502083848 |
Authorized person
| Name | DR. VISHNU NARAYAN BEHARI |
| Role | CHIEF EXECUTIVE OFFICER |
| Phone | 8502083848 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| License Number | 98582 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 279086600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BEHARI VISHNU MD | Agent | 9008 ASHVILLE DRIVE, PENSACOLA, FL, 32514 |
| Name | Role | Address |
|---|---|---|
| BEHARI VISHNU | Managing Member | 9008 ASHEVILLE DRIVE, PENSACOLA, FL, 32514 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2018-04-26 | 6160 N Davis Hwy, 10A, PENSACOLA, FL 32504 | No data |
| CHANGE OF MAILING ADDRESS | 2018-04-26 | 6160 N Davis Hwy, 10A, PENSACOLA, FL 32504 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-04-26 | 9008 ASHVILLE DRIVE, PENSACOLA, FL 32514 | No data |
| REINSTATEMENT | 2017-11-13 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2017-11-13 | BEHARI, VISHNU, MD | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J21000108419 | TERMINATED | 1000000879278 | ESCAMBIA | 2021-03-04 | 2031-03-10 | $ 692.78 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, PENSACOLA SERVICE CENTER, 2205 LA VISTA AVE STE B, PENSACOLA FL325048210 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-19 |
| ANNUAL REPORT | 2023-02-02 |
| ANNUAL REPORT | 2022-02-16 |
| ANNUAL REPORT | 2021-03-15 |
| ANNUAL REPORT | 2020-03-19 |
| ANNUAL REPORT | 2019-04-03 |
| ANNUAL REPORT | 2018-04-26 |
| REINSTATEMENT | 2017-11-13 |
| Florida Limited Liability | 2015-11-19 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
