| Entity Name: | MIAMI PEDIATRIC GASTROENTEROLOGY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 18 Mar 2016 (9 years ago) |
| Document Number: | L16000055266 |
| FEI/EIN Number | 81-1894645 |
| Address: | 8525 S.W. 92 STREET SUITE C-11A, MIAMI, FL 33156 |
| Mail Address: | 8525 S.W. 92 STREET SUITE C-11A, MIAMI, FL 33156 |
| ZIP code: | 33156 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1679937742 | 2016-04-05 | 2016-05-16 | 8525 SW 92ND ST, SUITE C-11A, MIAMI, FL, 331567365, US | 8525 SW 92ND ST, SUITE C-11A, MIAMI, FL, 331567365, US | |||||||||||||||
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| Phone | +1 305-512-3345 |
| Phone | +1 786-270-3900 |
Authorized person
| Name | RAGHAD KOUTOUBY |
| Role | MEMBER |
| Phone | 3055123345 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| KOUTOUBY, RAGHAD | Agent | 8525 S.W. 92 STREET SUITE C-11A, MIAMI, FL 33156 |
| Name | Role | Address |
|---|---|---|
| KOUTOUBY, RAGHAD | Member | 8525 S.W. 92 STREET, MIAMI, FL 33156 |
| LORET DE MOLA, OSCAR | Member | 8525 S.W. 92 STREET SUITE C-11A, MIAMI, FL 33156 |
| Name | Role | Address |
|---|---|---|
| KOUTOUBY, RAGHAD | Manager | 8525 S.W. 92 STREET, MIAMI, FL 33156 |
| LORET DE MOLA, OSCAR | Manager | 8525 S.W. 92 STREET SUITE C-11A, MIAMI, FL 33156 |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-01-31 |
| ANNUAL REPORT | 2024-01-29 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-04-29 |
| ANNUAL REPORT | 2021-04-07 |
| ANNUAL REPORT | 2020-01-06 |
| ANNUAL REPORT | 2019-01-02 |
| ANNUAL REPORT | 2018-03-24 |
| AMENDED ANNUAL REPORT | 2017-04-09 |
| ANNUAL REPORT | 2017-02-22 |
Date of last update: 20 Jan 2025
Sources: Florida Department of State
