| Entity Name: | MARK ALEXANDER FONSECA ARNP, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 18 Feb 2016 (9 years ago) |
| Date of dissolution: | 28 Sep 2018 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2018 (6 years ago) |
| Document Number: | L16000034146 |
| FEI/EIN Number | 81-1490273 |
| Address: | 10310 SW 142 COURT, MIAMI, FL 33186 |
| Mail Address: | 10310 SW 142 COURT, MIAMI, FL 33186 |
| ZIP code: | 33186 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1760991988 | 2017-09-20 | 2022-07-21 | 10310 SW 142ND CT, MIAMI, FL, 331868422, US | 51 SW 134TH CT, MIAMI, FL, 331841177, US | |||||||||||||||||||||||||
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| Phone | +1 786-493-6556 |
Authorized person
| Name | MR. MARK ALEXANDER FONSECA |
| Role | CCO |
| Phone | 7864936556 |
Taxonomy
| Taxonomy Code | 363LA2200X - Adult Health Nurse Practitioner |
| License Number | ARNP9309582 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 363LG0600X - Gerontology Nurse Practitioner |
| License Number | ARNP9309582 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| FONSECA, MARK A | Agent | 10310 SW 142 COURT, MIAMI, FL 33186 |
| Name | Role | Address |
|---|---|---|
| FONSECA, MARK A | Authorized Member | 10310 SW 142 COURT, MIAMI, FL 33186 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-04-14 |
| Florida Limited Liability | 2016-02-18 |
Date of last update: 20 Jan 2025
Sources: Florida Department of State
