| Entity Name: | SUPRA MEDICAL GROUP II, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 23 Nov 2016 (8 years ago) |
| Document Number: | L16000214463 |
| FEI/EIN Number | 81-4532929 |
| Address: | 10300 SW 72ND STREET, MIAMI, FL, 33173, US |
| Mail Address: | 10300 SW 72ND STREET, MIAMI, FL, 33173, US |
| ZIP code: | 33173 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1205592656 | 2021-11-10 | 2021-11-10 | 10300 SW 72ND ST STE 387, MIAMI, FL, 331733020, US | 10300 SW 72ND ST STE 387, MIAMI, FL, 331733020, US | |||||||||||||||||||
|
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| Phone | +1 305-200-5210 |
| Fax | 3052005780 |
Authorized person
| Name | KLEYDSON DA SILVA |
| Role | CEO |
| Phone | 3052005210 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | Yes |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| NEVES DA SILVA KLEYDSON | Agent | 10300 SW 72ND STREET, MIAMI, FL, 33173 |
| Name | Role | Address |
|---|---|---|
| NEVES DA SILVA KLEYDSON | Manager | 10300 SW 72ND STREET, MIAMI, FL, 33173 |
| Oliva Iliana | Manager | 10300 SW 72ND STREET, MIAMI, FL, 33173 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2022-10-17 | NEVES DA SILVA, KLEYDSON | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-06-23 | 10300 SW 72ND STREET, Suite 101, MIAMI, FL 33173 | No data |
| CHANGE OF MAILING ADDRESS | 2020-06-23 | 10300 SW 72ND STREET, Suite 101, MIAMI, FL 33173 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-06-23 | 10300 SW 72ND STREET, Suite 101, MIAMI, FL 33173 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-03-28 |
| AMENDED ANNUAL REPORT | 2022-10-17 |
| ANNUAL REPORT | 2022-04-29 |
| ANNUAL REPORT | 2021-04-21 |
| ANNUAL REPORT | 2020-06-23 |
| ANNUAL REPORT | 2019-02-19 |
| ANNUAL REPORT | 2018-01-09 |
| AMENDED ANNUAL REPORT | 2017-05-17 |
| ANNUAL REPORT | 2017-02-10 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
