| Entity Name: | CUTLER BAY DENTAL SPECIALTY, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 26 Apr 2016 (9 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 24 Apr 2024 (9 months ago) |
| Document Number: | L16000082166 |
| FEI/EIN Number | 81-2396703 |
| Mail Address: | 6240 LAKE OSPREY DRIVE, SARASOTA, FL 34240 UN |
| Address: | 20529 OLD CUTLER ROAD, CUTLER BAY, FL 33189 |
| ZIP code: | 33189 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174979496 | 2016-05-05 | 2016-05-05 | 13195 SW 134TH ST, MIAMI, FL, 331864461, US | 20529 OLD CUTLER RD, CUTLER BAY, FL, 331892454, US | |||||||||||||||||||||||||
|
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| Phone | +1 305-274-2499 |
Authorized person
| Name | STEPHANIE GOMEZ |
| Role | CREDENTIALING COORDINATOR |
| Phone | 3052742499 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| Is Primary | Yes |
| Taxonomy Code | 1223E0200X - Endodontist |
| Is Primary | No |
| Taxonomy Code | 1223P0300X - Periodontist |
| Is Primary | No |
| Taxonomy Code | 1223S0112X - Oral and Maxillofacial Surgery (Dentist) |
| Is Primary | No |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| GALLO, DONALD | DIRECTOR | 6240 LAKE OSPREY DRIVE, SARASOTA 34240 UN |
| Name | Role | Address |
|---|---|---|
| Ribeiro, Alexandre | Manager | 6240 LAKE OSPREY DRIVE, SARASOTA 34240 UN |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000110103 | DENTAL SPECIALTY CENTER OF CUTLER BAY | EXPIRED | 2016-10-10 | 2021-12-31 | No data | 6240 LAKE OSPREY DRIVE, SARASOTA, FL, 34240 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC STMNT OF RA/RO CHG | 2024-04-24 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2024-04-24 | C T CORPORATION SYSTEM | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-24 | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-07-24 |
| CORLCRACHG | 2024-04-24 |
| ANNUAL REPORT | 2023-04-12 |
| ANNUAL REPORT | 2022-04-26 |
| ANNUAL REPORT | 2021-04-28 |
| ANNUAL REPORT | 2020-06-29 |
| ANNUAL REPORT | 2019-04-19 |
| ANNUAL REPORT | 2018-04-17 |
| ANNUAL REPORT | 2017-04-03 |
| Florida Limited Liability | 2016-04-26 |
Date of last update: 20 Jan 2025
Sources: Florida Department of State
