| Entity Name: | BREAST RECONSTRUCTION SPECIALISTS, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 08 Apr 2016 (9 years ago) |
| Date of dissolution: | 22 Sep 2017 (7 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2017 (7 years ago) |
| Document Number: | L16000069439 |
| Address: | 27716 CASHFORD CIRCLE, SUITE 102B, WESLEY CHAPEL, FL, 33544, US |
| Mail Address: | 27716 CASHFORD CIRCLE, SUITE 102B, WESLEY CHAPEL, FL, 33544, US |
| ZIP code: | 33544 |
| County: | Pasco |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598116212 | 2016-06-23 | 2016-06-23 | 27716 CASHFORD CIR, FLEET 102B, WESLEY CHAPEL, FL, 335446962, US | 27716 CASHFORD CIR, FLEET 102B, WESLEY CHAPEL, FL, 335446962, US | |||||||||||||||||
|
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| Phone | +1 813-406-4448 |
Authorized person
| Name | DR. RAJ AMBAY |
| Role | BOARD CERTIFIED PLASTIC SURGEON |
| Phone | 8134064448 |
Taxonomy
| Taxonomy Code | 261QM2500X - Medical Specialty Clinic/Center |
| License Number | ME109483 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SCHICK DAVID LESQ. | Agent | 200 S. ORANGE AVENUE, SUITE 2300, ORLANDO, FL, 32801 |
| Name | Role | Address |
|---|---|---|
| AMBAY RAJ S | Manager | 22716 CASHFORD CIRCLE, WESLEY CHAPEL, FL, 33544 |
| BASU C BOB M.D. | Manager | 22716 CASHFORD CIRCLE, WESLEY CHAPEL, FL, 33544 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| Name | Date |
|---|---|
| Reg. Agent Resignation | 2023-03-24 |
| Florida Limited Liability | 2016-04-08 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
