| Entity Name: | CRISTAL SUN MEDICAL GROUP LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 18 Jul 2016 (9 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year ago) |
| Document Number: | L16000134658 |
| FEI/EIN Number | 81-3313838 |
| Address: | 3511 SW 145TH AVE, MIRAMAR, FL, 33027, US |
| Mail Address: | 3511 SW 145TH AVE, MIRAMAR, FL, 33027, US |
| ZIP code: | 33027 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1528411865 | 2016-07-21 | 2016-07-21 | 3470 E COAST AVE, APT 2005, MIAMI, FL, 331373986, US | 3470 E COAST AVE, APT 2005, MIAMI, FL, 331373986, US | |||||||||||||||||
|
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| Phone | +1 305-781-2662 |
Authorized person
| Name | DR. SUZANNE BEN-KANE |
| Role | PARTNER |
| Phone | 3057812662 |
Taxonomy
| Taxonomy Code | 208M00000X - Hospitalist Physician |
| License Number | ME125973 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Clavijo Liliana CDr. | Agent | 3511 SW 145TH AVE, MIRAMAR, FL, 33027 |
| Name | Role | Address |
|---|---|---|
| Clavijo Cristina CDr. | Chief Executive Officer | 3511 SW 145TH AVE, MIRAMAR, FL, 33027 |
| Name | Role | Address |
|---|---|---|
| Clavijo Cristina cDr. | Auth | 3511 SW 145TH AVE, MIRAMAR, FL, 33027 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-05-01 | 3511 SW 145TH AVE, MIRAMAR, FL 33027 | No data |
| CHANGE OF MAILING ADDRESS | 2021-05-01 | 3511 SW 145TH AVE, MIRAMAR, FL 33027 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-05-01 | 3511 SW 145TH AVE, MIRAMAR, FL 33027 | No data |
| REGISTERED AGENT NAME CHANGED | 2020-04-10 | Clavijo, Liliana C, Dr. | No data |
| REINSTATEMENT | 2020-04-10 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2022-05-28 |
| ANNUAL REPORT | 2021-05-01 |
| REINSTATEMENT | 2020-04-10 |
| ANNUAL REPORT | 2018-06-01 |
| ANNUAL REPORT | 2017-06-27 |
| Florida Limited Liability | 2016-07-18 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
