| Entity Name: | DAVID OMOBASUYI LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 20 Dec 2016 (8 years ago) |
| Date of dissolution: | 25 Sep 2020 (4 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2020 (4 years ago) |
| Document Number: | L16000229320 |
| FEI/EIN Number | 81-4852709 |
| Address: | 15716 SW 26TH STREET, MIRAMAR, FL 33027 |
| Mail Address: | 15716 SW 26TH STREET, MIRAMAR, FL 33027 |
| ZIP code: | 33027 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1255824355 | 2018-06-13 | 2018-06-13 | 15716 SW 26TH ST, MIRAMAR, FL, 330274271, US | 9701 W OAKLAND PARK BLVD, SUNRISE, FL, 333517015, US | |||||||||||||||||||||
|
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| Phone | +1 305-898-7006 |
| Fax | 3058987006 |
| Phone | +1 954-572-4444 |
Authorized person
| Name | DR. DAVID OMOBASUYI |
| Role | PRESIDENT |
| Phone | 3058987006 |
Taxonomy
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| License Number | 2870242 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| OMOBASUYI, DAVID | Agent | 15716 SW 26TH STREET, MIRAMAR, FL 33027 |
| Name | Role | Address |
|---|---|---|
| OMOBASUYI, DAVID | Manager | 15716 SW 26TH STREET, MIRAMAR, FL 33027 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000129595 | PIMEPSYCH SOLUTIONS | EXPIRED | 2018-12-07 | 2023-12-31 | No data | 15716 SW 26TH STREET, MIRAMAR, FL, 33027 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2019-04-05 |
| ANNUAL REPORT | 2018-04-02 |
| Florida Limited Liability | 2016-12-20 |
Date of last update: 18 Feb 2025
Sources: Florida Department of State
